NICKOLAS TYLER MCCLELLAN

SAN DIEGO, CA
NPI1033625835
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2017-12-17
Last Update Date2017-12-17
Business Address
NICKOLAS TYLER MCCLELLAN IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number: 619-532-6825
Mailing Address
NICKOLAS TYLER MCCLELLAN IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number:
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