KRISTOFFER RAY TIERRA COLLERA

SAN DIEGO, CA
NPI1174033351
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2017-10-02
Last Update Date2017-10-02
Business Address
KRISTOFFER RAY TIERRA COLLERA
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number: 619-532-7968
Mailing Address
KRISTOFFER RAY TIERRA COLLERA
6516 FRIARS RD APT 103
SAN DIEGO, CA 92108-1037
Phone number:
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