Individual
MR. TIMOTHY J. KERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DIVE IDC
Contact information
Practice address
4643 DOCK RD BLDG 524, PORT HUENEME, CA 93043-4321
(805) 982-6682
Mailing address
4643 DOCK RD BLDG 524, PORT HUENEME, CA 93043-4321
(805) 982-6682
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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