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1891949616
TERRY DWAYNE SHOULDERS
SAN DIEGO, CA
NPI
1891949616
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider Independent Duty Corpsman
Enumeration Date
2008-11-06
Last Update Date
2008-11-06
Business Address
TERRY DWAYNE SHOULDERS IDC
3402 TARAWA RD. SPECIAL BOAT TEAM TWELVE MEDICAL DEPARTMENT
SAN DIEGO, CA 92155-5003
Phone number: 619-437-5540
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Mailing Address
TERRY DWAYNE SHOULDERS IDC
3375 GREGORY ST
SAN DIEGO, CA 92104-4751
Phone number: 760-668-5569
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