Individual
MR. STEVEN LEE UNDHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 546-7094
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 546-7094
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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