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Individual

VIRGIL ALLEN NEWTON

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
(805) 982-3246
Mailing address
4643 DOCK RD BLDG 524, PORT HUENEME, CA 93043-4321
(805) 982-6682
(805) 982-3246

Taxonomy

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

Other

Enumeration date
01/20/2016
Last updated
01/20/2016
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