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1184046815
MICHAEL THOMAS SHORT
SAN DIEGO, CA
NPI
1184046815
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2014-01-15
Last Update Date
2014-01-15
Business Address
-- MICHAEL THOMAS SHORT
15034 AVENIDA MONTUOSA APT B
SAN DIEGO, CA 92129-1442
Phone number: 949-682-6918
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Mailing Address
-- MICHAEL THOMAS SHORT
15034 AVENIDA MONTUOSA APT B
SAN DIEGO, CA 92129-1442
Phone number: 949-682-6918
Copy
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