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1013267996
ALONZO JAMELLE SHIELDS
TWENTYNINE PALMS, CA
NPI
1013267996
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: AL 7244689)
Enumeration Date
2012-09-18
Last Update Date
2012-09-18
Business Address
-- ALONZO JAMELLE SHIELDS IDC
REGIMENTAL AID STATION 7TH MARINE HQ RAS
TWENTYNINE PALMS, CA 92278
Phone number: 334-370-7078
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Mailing Address
-- ALONZO JAMELLE SHIELDS IDC
BOX 788-260 2ND MARINE REGIMENT STATION
TWENTYNINE PALMS, CA 92278-8266
Phone number: 334-370-7078
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