Individual
MR. JUSTIN CARL CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1405 LEYTE RD APT D, CORONADO, CA 92118-3185
(513) 800-6866
Mailing address
1405 LEYTE RD APT D, CORONADO, CA 92118-3185
(513) 800-6866
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/22/2026
Last updated
05/22/2026
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