Individual
RITA MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HS1
Contact information
Practice address
COMMANDING OFFICER US COAST GUARD SUPRTCEN ELIZABETH C, WEEKSVILLE RD BLDG 128, ELIZABETH CITY, NC 27909
(252) 335-6460
Mailing address
COMMANDING OFFICER US COAST GUARD SUPRTCEN ELIZABETH C, WEEKSVILLE RD BLDG 128, ELIZABETH CITY, NC 27909
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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