JASON THOMAS WILLIAM TETZLAFF

SAN DIEGO, CA
NPI1043247091
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: AZ  2099)
Additional Taxonomies174400000X Specialist
171000000X Military Health Care Provider
(Licence: CA  2099)
Enumeration Date2006-06-26
Last Update Date2008-04-22
Business Address
Mr. JASON THOMAS WILLIAM TETZLAFF IDC
3402 TARAWA RD SBT-12
SAN DIEGO, CA 92155-5176
Phone number: 619-437-5539
Mailing Address
Mr. JASON THOMAS WILLIAM TETZLAFF IDC
4742 GAINARD WAY
SAN DIEGO, CA 92124-2913
Phone number: 619-436-8538