Individual
MR. JUSTIN ANDREW WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
1ST MARINE SPECIAL OPERATIONS BATTALION, MEDICAL DEPARTMENT, CAMP PENDLETON, CA 92055-5341
(760) 725-5298
Mailing address
1ST MARINE SPECIAL OPERATIONS BATTALION, MEDICAL DEPARTMENT, CAMP PENDLETON, CA 92055-5341
(760) 725-5298
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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