Individual
KASEY RYAN NORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STUDENT
Contact information
Practice address
8281 GOLD COAST DR UNIT 5, SAN DIEGO, CA 92126-3686
(325) 665-9403
Mailing address
8281 GOLD COAST DR UNIT 5, SAN DIEGO, CA 92126-3686
(325) 665-9403
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
12/13/2022
Last updated
06/05/2023
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