Individual
RYAN KITCHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4643 DOCK ROAD BUILDING 524, PORT HUENEME, CA 93043
(817) 944-4077
Mailing address
4643 DOCK ROAD BUILDING 524, PORT HUENEME, CA 93043
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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