Organization
KENNER ARMY HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH EUGENE WATSON (LICENSED PRACTICAL NURSE)
(804) 734-9449
Entity
Organization
Contact information
Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9449
(804) 734-9053
Mailing address
11719 WALNUT WOOD CT, MIDLOTHIAN, VA 23112-3268
(804) 595-1602
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
0002041915
VA
Other
Enumeration date
04/23/2007
Last updated
08/12/2008
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