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1316725633
THOMAS CLEON JORGENSEN
SAN DIEGO, CA
NPI
1316725633
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider Independent Duty Corpsman
Enumeration Date
2023-09-18
Last Update Date
2023-09-18
Business Address
THOMAS CLEON JORGENSEN DEEP SEA DIVING IDC
4588 50TH ST
SAN DIEGO, CA 92115-3305
Phone number: 850-530-5141
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Mailing Address
THOMAS CLEON JORGENSEN DEEP SEA DIVING IDC
4588 50TH ST
SAN DIEGO, CA 92115-3305
Phone number: 850-530-5141
Copy
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