Organization
AIR FORCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISAIAH GARY ALLISON (IDMT)
(360) 589-6025
Entity
Organization
Contact information
Practice address
690 BARNES BLVD, MCCHORD AFB, WA 98438-0000
(253) 982-5688
Mailing address
690 BARNES BLVD, MCCHORD AFB, WA 98438-0000
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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