Organization
17TH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES FORREST (COLONEL)
(325) 654-3075
Entity
Organization
Contact information
Practice address
271 FORT RICHARDSON AVE, GOODFELLOW AFB, TX 76908-4901
(325) 654-5238
Mailing address
1407 GREGORY DR, SAN ANGELO, TX 76905-4213
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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