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Individual

MR. GARRETT BLAZE DEARING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SOIDC

Contact information

Practice address
BLDG 4130077 EAST MARSOC, 1ST MARINE SPECIAL OPERATIONS BATALLION, CAMP PENDLETON, CA 92055-5020
(760) 725-5298
Mailing address
BLDG 4130077 EAST MARSOC, 1ST MARINE SPECIAL OPERATIONS BATALLION, CAMP PENDLETON, CA 92055-5020

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary

Other

Enumeration date
04/09/2012
Last updated
04/09/2012
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