Individual
NICHOLAS FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
4101 STUART MESA ROAD, CAMP PENDLETON, CA 92055
(760) 763-2118
Mailing address
1ST RECONNAISSANCE BATTALION, PSC BOX 555584, 4101 STUART MESA ROAD, CAMP PENDLETON, CA 92055
(540) 446-9171
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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