MARTIN LEE DIERKS

DE SOTO, MO
NPI1902132434
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2009-10-17
Last Update Date2009-10-17
Business Address
-- MARTIN LEE DIERKS IDC
2915 PARTHENON DR
DE SOTO, MO 63020-4645
Phone number: 757-650-8436
Mailing Address
-- MARTIN LEE DIERKS IDC
2915 PARTHENON DR
DE SOTO, MO 63020-4645
Phone number: 757-650-8436