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Individual

RICKY HOLBERT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
10219 LAFFEY CT, SAN DIEGO, CA 92124-2918
(864) 216-1415
Mailing address
10219 LAFFEY CT, SAN DIEGO, CA 92124-2918
(864) 216-1415

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
08/07/2023
Last updated
08/07/2023
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