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1508417510
MATTHEW HART
SAN DIEGO, CA
NPI
1508417510
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2019-09-23
Last Update Date
2019-09-23
Business Address
Mr. MATTHEW HART
3400 BOB WILSON DRIVE
SAN DIEGO, CA 92134-0001
Phone number: 912-547-4013
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Mailing Address
Mr. MATTHEW HART
6829 GA HIGHWAY 17 S
BLOOMINGDALE, GA 31302-4610
Phone number: 912-547-4013
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