Individual
RYAN NEWKIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
4319 TOPAZ CT APT 244, LA MESA, CA 91941-8426
(586) 335-0812
Mailing address
4319 TOPAZ CT APT 244, LA MESA, CA 91941-8426
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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