JERRY M SMITH

PORT HUENEME, CA
NPI1659460590
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2006-10-11
Last Update Date2007-07-08
Business Address
Mr. JERRY M SMITH IDC
4643 DOCK RD BLDG 524
PORT HUENEME, CA 93043-4321
Phone number: 805-982-2411
Mailing Address
Mr. JERRY M SMITH IDC
10213 TRUETT LN
SAN DIEGO, CA 92124-3642
Phone number: 360-689-0241