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1629410923
JERRY K ROSHELL
SAN DIEGO, CA
NPI
1629410923
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2013-07-27
Last Update Date
2013-07-27
Business Address
Mr. JERRY K ROSHELL
6077 FAUNA DR
SAN DIEGO, CA 92115-8215
Phone number: 414-530-4079
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Mailing Address
Mr. JERRY K ROSHELL
6077 FAUNA DR
SAN DIEGO, CA 92115-8215
Phone number: 414-530-4079
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