Individual
KAMEO LYN GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
COMDT (CG-1122) US COAST GUARD, 2100 2ND ST SW SUITE 5314, WASHINGTON, DC 20593
(707) 765-7774
Mailing address
431 ALASKA AVE APT D, PETALUMA, CA 94952-9112
(707) 765-7774
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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