Spencer Corey Southerland, IDC - Fpo, AE

Spencer Corey Southerland, IDC

Military Health Care Provider in Fpo, N/A

NPI 1922359702

Spencer Corey Southerland is a Military Health Care Provider based in Fpo, . Spencer Corey Southerland practices in Fpo, and has the professional credentials of IDC. The NPI Number for Spencer Corey Southerland is 1922359702 and holds a License No. (N/A).

The current practice location address for Spencer Corey Southerland is Seal Team 2, Fpo, and can be reached out via phone at 360-286-0972.

Location: Seal Team 2, Fpo, , 09501-4633

NPI Number

1922359702

Provider Name

Spencer Corey Southerland

Credential

IDC

Provider Entity Type

Individual

Gender

Male

Address

Seal Team 2, Fpo, , 09501-4633

Phone Number

360-286-0972

Fax Number

Provider Enumeration Date

09/20/2012

Last Update Date

03/09/2024

Address

Seal Team 2

City

Fpo

State

Zip

09501-4633

Phone Number

360-286-0972

Fax Number

Address

Seal Team 2

City

Fpo

State

Zip

09501-4633

Phone Number

360-286-0972

Fax Number

Type

Other Service Providers

Classification

Military Health Care Provider

Speciality

Taxonomy

171000000X

License No.

()

Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

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