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1003272485
JASON DEDEKER
PORTSMOUTH, VA
NPI
1003272485
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2016-01-14
Last Update Date
2016-01-14
Business Address
-- JASON DEDEKER
620 JOHN PAUL JONES CIR NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH, VA 23708-2197
Phone number: 757-953-5257
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Mailing Address
-- JASON DEDEKER
3849 WILHOIT RD
APISON, TN 37302-9783
Phone number:
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