MICHAEL BLAKE COLLINS

SAN DIEGO, CA
NPI1346612702
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2015-10-26
Last Update Date2015-10-26
Business Address
Mr. MICHAEL BLAKE COLLINS SFIDC
10255 LAFFEY CT
SAN DIEGO, CA 92124-2918
Phone number: 757-647-2668
Mailing Address
Mr. MICHAEL BLAKE COLLINS SFIDC
10255 LAFFEY CT
SAN DIEGO, CA 92124-2918
Phone number: 757-647-2668