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Individual

RYAN HOUTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6748 TUXEDO RD, SAN DIEGO, CA 92119-1541
(760) 978-7448
Mailing address
6748 TUXEDO RD, SAN DIEGO, CA 92119-1541

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
27158425
PA

Other

Enumeration date
02/02/2015
Last updated
02/02/2015
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