Individual
MR. DWIGHT HUNTER KOONTZ II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE, BUILDING 14, SAN DIEGO, CA 92134-7000
(619) 543-0000
Mailing address
34101 FARENHOLT AVE, SAN DIEGO, CA, APO, AA 92134
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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