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MR. RETH EL IDMT

Independent Duty Medical Technicians >> Military Health Care Provider >> Other Service Providers

Registrant NPI Number: 1033353529

Individual Registrant:
MR. RETH  EL IDMT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
113 HOWIE WALTERS RD  HURLBURT FIELD, FL 32544-5668 US
Tel: 850-884-1168  Fax: --

Contact information for business:
225 BENNETT AVE 1SOSS/OSM HURLBURT FIELD, FL 32544-5707 US
Tel: 850-884-1168  Fax: --

Registration Information:
NPI: 1033353529
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1710I1003XOther Service Providers
Military Health Care Provider
Independent Duty Medical Technicians

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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