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1912342536
LON PHILLIP CHANEY
SAN DIEGO, CA
NPI
1912342536
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2013-05-09
Last Update Date
2013-05-09
Business Address
-- LON PHILLIP CHANEY IDC
2626 SHOUP DR
SAN DIEGO, CA 92110-4268
Phone number: 757-641-3994
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Mailing Address
-- LON PHILLIP CHANEY IDC
2626 SHOUP DR
SAN DIEGO, CA 92110-4268
Phone number: 757-641-3994
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