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Individual

BENJAMIN WILLIS ROZEBOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-6400
Mailing address
9 COOSAWHATCHIE WAY, BEAUFORT, SC 29906-6039
(910) 381-5881

Taxonomy

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

Other

Enumeration date
09/18/2023
Last updated
09/18/2023
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