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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
VA |
261QV0200X |
| NPI Number | 1902847593 |
| LBN Legal business name | MANCHESTER CBOC |
| Authorized official | BARBARA MAYERICK - (DIRECTOR, BUSINESS DEVELOPMENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 06/08/2006 |
| Last updated | 08/22/2020 - About 6 years ago |
| Identifiers | n/a |
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MANCHESTER CBOC
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