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1043516610
CHARLES DELVON PICKETT
LUKE AFB, AZ
NPI
1043516610
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date
2011-01-31
Last Update Date
2011-08-30
Business Address
-- CHARLES DELVON PICKETT IDMT
7019 N LITCHFIELD AVE LUKE AFB, 56/AMDS
LUKE AFB, AZ 85309
Phone number: 623-856-7527
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Mailing Address
-- CHARLES DELVON PICKETT IDMT
16240 W PIMA ST
GOODYEAR, AZ 85338-7927
Phone number: 480-233-5021
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