Individual
DANIEL LEE MAYBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
3D MARDIV DET, REGIMENTAL AID STATION, M C B H KANEOHE BAY, HI 96863
(808) 343-7780
Mailing address
3D MARDIV DET, REGIMENTAL AID STATION, M C B H KANEOHE BAY, HI 96863
(808) 343-7780
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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