GEORGE CONRAD FASTENAU

CAMP LEJEUNE, NC
NPI1386851574
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2007-05-17
Last Update Date2007-07-08
Business Address
-- GEORGE CONRAD FASTENAU Navy IDC
2ND CEB BAS 2D MARDIV II MEF
CAMP LEJEUNE, NC 28542
Phone number: 910-451-7989
Mailing Address
-- GEORGE CONRAD FASTENAU Navy IDC
5179 COLORADO AVE
CAMP LEJEUNE, NC 28547-1126
Phone number: 910-451-7989