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Individual

ROY ATALLAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
2ND MARINE RAIDER BATTALION, CAMP LEJEUNE, NC 28542
(508) 272-2518
Mailing address
2ND MARINE RAIDER BATTALION, PSC BOX 20183, CAMP LEJEUNE, NC 28542

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
10/01/2018
Last updated
10/01/2018
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