NPI 1104054659

Ronnie Lee Godbolt, IDMT

Practitioner Independent Duty Medical Technicians Charleston Afb, SC

Practice location

Address: 204 W Hill Blvd, Charleston Afb, SC 29404-4704
Phone: (843) 963-6936
Fax: (843) 963-6903

Registered specialties

Independent Duty Medical Technicians Primary

Other Service Providers Taxonomy 1710I1003X

Other Military Health Care Provider providers in South Carolina →

Registry record

NPI: 1104054659
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jun 2009
Record last updated: 23 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.