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Individual

NATHAN DYSKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SFIDC

Contact information

Practice address
BLDG 14008 16TH ST, 1ST MLG, CLR-17 RAS, CAMP PENDLETON, CA 92055
(760) 725-6180
Mailing address
BLDG 14008 16TH ST, 1ST MLG, CLR-17 RAS, CAMP PENDLETON, CA 92055
(760) 725-6180

Taxonomy

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

Other

Enumeration date
10/07/2011
Last updated
10/07/2011
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