Individual
KATELYN MOORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
1637 PASEO AURORA, SAN DIEGO, CA 92154-4861
(360) 908-1985
Mailing address
1637 PASEO AURORA, SAN DIEGO, CA 92154-4861
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/05/2011
Last updated
08/05/2011
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