RICKY WILLIAM BRETTHAUER

FT CARSON, CO
NPI1164575072
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2007-01-22
Last Update Date2007-07-08
Business Address
Mr. RICKY WILLIAM BRETTHAUER
1853 OCONNELL BLVD BLDG 1042
FT CARSON, CO 80913-4055
Phone number: 719-524-4670
Mailing Address
Mr. RICKY WILLIAM BRETTHAUER
5510 WHISKEY RIVER DR
COLORADO SPRINGS, CO 80922-4110
Phone number: 719-550-9196