MR. Randall Frederick Dierking JR., IDC

NPI #1790752111 in Groton, Connecticut

Provider Information

NPI Number
1790752111
Entity Type
Individual
Name
MR. Randall Frederick Dierking JR., IDC
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Military Health Care Provider - Independent Duty Corpsman
Credential
IDC
Enumeration Date
Mar 3, 2006
Last Updated
May 3, 2010

Practice Location

Address
1 WAHOO AVE
Address 2
UNDERSEA MEDICINE
City
Groton
ZIP Code
06340-2324
Phone
(860) 449-4247

Specialties & Taxonomy Codes

Specialty
Military Health Care Provider - Independent Duty CorpsmanIndependent Duty Corpsman

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