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1235682055
DWIGHT HUNTER KOONTZ
SAN DIEGO, CA
NPI
1235682055
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2016-07-28
Last Update Date
2016-07-28
Business Address
Mr. DWIGHT HUNTER KOONTZ IDC
34101 FARENHOLT AVE BUILDING 14
SAN DIEGO, CA 92134-7000
Phone number: 619-543-0000
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Mailing Address
Mr. DWIGHT HUNTER KOONTZ IDC
34101 FARENHOLT AVE SAN DIEGO, CA
APO, AA 92134
Phone number:
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