Individual
JON RUDOLF PANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
INDEPENDENT DUTY HM
Contact information
Practice address
4432 BONNEY RD, APARTMENT 206, VIRGINIA BEACH, VA 23462-3889
(619) 847-5977
Mailing address
4432 BONNEY RD, APARTMENT 206, VIRGINIA BEACH, VA 23462-3889
(619) 847-5977
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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