Individual
CARL MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA,CRA,ARRT(R)(CT)
Contact information
Practice address
MADIGAN ARMY MEDICAL CTR, 9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-2147
(253) 968-2024
Mailing address
MADIGAN ARMY MEDICAL CTR, 9040 JACKSON AVE ATTN:MCHJ-CLQ-C, TACOMA, WA 98431-1100
(253) 968-2147
(253) 968-2024
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
203671
—
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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