Individual
JUSTIN MICHAEL STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HEALTH SERVICE TECH
Contact information
Practice address
USCG COMDT CG-1122 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(757) 856-2230
(757) 856-2276
Mailing address
USCG COMDT CG-1122 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(757) 856-2230
(757) 856-2276
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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