Organization
NAVY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER CRUMPLER (IDC MANAGER)
(804) 457-4105
Entity
Organization
Contact information
Practice address
4311 WINDSOR LAKE DR, LOUISA, VA 23093-2135
(804) 457-4105
Mailing address
PSC 807 BOX 33, FPO, AE 09729-0002
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
—
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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