Individual
MR. JERRY K ROSHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6077 FAUNA DR, SAN DIEGO, CA 92115-8215
(414) 530-4079
Mailing address
6077 FAUNA DR, SAN DIEGO, CA 92115-8215
(414) 530-4079
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/27/2013
Last updated
07/27/2013
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