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1265401673
RANDY SCOTT BREIDEL
VIRGINIA BEACH, VA
NPI
1265401673
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2006-03-16
Last Update Date
2022-07-21
Business Address
Mr. RANDY SCOTT BREIDEL Sub IDC
DAM NECK ANNEX 1885 TERRIER AVE STE 100
VIRGINIA BEACH, VA 23461-2298
Phone number: 757-314-7221
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Mailing Address
Mr. RANDY SCOTT BREIDEL Sub IDC
761 DWYER RD
VIRGINIA BEACH, VA 23454-6924
Phone number: 757-689-8742
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