Individual
ROHN DALE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUBMARINE IDC
Contact information
Practice address
USS OHIO SSGN 726 GOLD, SILVERDALE, WA 98312
(360) 476-8351
Mailing address
4417 WATERMAN RIDGE LN E, PORT ORCHARD, WA 98366-8001
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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