Individual
MR. CLYDE NOBLES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
375 MDG, SCOTT AFB, IL 62225
(618) 256-7551
Mailing address
375 MDG, SCOTT AFB, IL 62225
(618) 256-7551
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
05/07/2009
Last updated
05/07/2009
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