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1003585399
DESMOND JACOB MARROQUIN
SHAW AFB, SC
NPI
1003585399
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date
2021-09-09
Last Update Date
2024-11-26
Business Address
DESMOND JACOB MARROQUIN
420 POLIFKA DR
SHAW AFB, SC 29152-5100
Phone number: 803-885-0249
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Mailing Address
DESMOND JACOB MARROQUIN
420 POLIFKA DR
SHAW AFB, SC 29152-5100
Phone number: 803-885-0249
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