Organization
62 MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TESSIE M RIOS (CREDENTIALS MANAGER)
(253) 982-9918
Entity
Organization
Contact information
Practice address
690 BARNES BLVD, ATTN: SGHC, MCCHORD AFB, WA 98438
(253) 982-9918
(253) 982-0283
Mailing address
690 BARNES BLVD, ATTN: SGHC, MCCHORD AFB, WA 98438
(253) 982-9918
(253) 982-0283
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/08/2006
Last updated
06/13/2008
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