Individual
THOMAS POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2609 W CANYON AVE, APT 307, SAN DIEGO, CA 92123-4729
(972) 730-5399
Mailing address
2609 W CANYON AVE, APT 307, SAN DIEGO, CA 92123-4729
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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