Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
VA |
261QV0200X |
| NPI Number | 1508278086 |
| LBN Legal business name | MANN GRANDSTAFF VA MEDICAL CENTER |
| Authorized official | CHAD GOSNELL - (CHIEF OF OPTOMETRY) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 06/02/2014 |
| Last updated | 06/02/2014 - About 12 years ago |
| Identifiers | n/a |
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