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Individual

ROONG ROBERT BURKET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
347 OSS OSM, MOODY A F B, GA 31699-0001
(229) 257-3874
Mailing address
2467 MUSCOGEE DR, VALDOSTA, GA 31602-5720
(229) 444-4540

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
06/15/2009
Last updated
06/15/2009
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