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1922359702
SPENCER COREY SOUTHERLAND
FPO, AE
NPI
1922359702
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171000000X Military Health Care Provider
Enumeration Date
2012-09-20
Last Update Date
2012-09-20
Business Address
-- SPENCER COREY SOUTHERLAND IDC
SEAL TEAM 2 UNIT 60003
FPO, AE 09501-4633
Phone number: 360-286-0972
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Mailing Address
-- SPENCER COREY SOUTHERLAND IDC
SEAL TEAM 2 UNIT 60003
FPO, AE 09501-4633
Phone number:
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