Individual
MR. DWAYNE ROOSEVELT KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
314 W MAGNOLIA ST, COMPTON, CA 90220-2104
(310) 531-4963
Mailing address
314 W MAGNOLIA ST, COMPTON, CA 90220-2104
(310) 531-4963
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/03/2013
Last updated
06/03/2013
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