Organization
ISC PORTSMOUTH VA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAD ALLEN (COMMADANT USCG)
(757) 483-8596
Entity
Organization
Contact information
Practice address
4000 COASTGUARD BLVD., PORTSMOUTH, VA 23703
(757) 483-8596
(757) 483-8610
Mailing address
4000 COASTGUARD BLVD., PORTSMOUTH, VA 23703
(757) 483-8596
(757) 483-8610
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
08/08/2008
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