Organization
USCG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WYATT HELLEY (HEALTH SERVICE TECHNICAN 3 CLASS)
(508) 968-6704
Entity
Organization
Contact information
Practice address
5439 A LEMAY AVE., BUZZARDS BAY, MA 02542
(508) 968-6704
Mailing address
5403 A LEMAY AVE., BUZZARDS BAY, MA 02542
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
04/02/2007
Last updated
08/22/2020
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