Individual
MIKE COCKRILL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
UNDERWATER CONSTRUCTION TEAM 2, 4643 DOCK ROAD, BLDG 524, PORT HUENEME, CA 93043-0001
(805) 982-2464
(805) 982-3246
Mailing address
2609 ABALONE CV, PORT HUENEME, CA 93041-1546
(757) 575-6336
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
03/10/2006
Last updated
07/08/2007
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