COLLIN JOHN WISEMAN

SAN DIEGO, CA
NPI1841705910
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2017-12-11
Last Update Date2017-12-11
Business Address
Mr. COLLIN JOHN WISEMAN SFIDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-532-7968
Mailing Address
Mr. COLLIN JOHN WISEMAN SFIDC
10190 COWELL CT
SAN DIEGO, CA 92124-2905
Phone number: 443-510-5803