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1326892472
JAKE E DERTINGER
FORT BLISS, TX
NPI
1326892472
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-04-15
Last Update Date
2024-04-15
Business Address
JAKE E DERTINGER
18511 HIGHLANDER MEDICS ST
FORT BLISS, TX 79906-5327
Phone number: 915-742-0576
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Mailing Address
JAKE E DERTINGER
18511 HIGHLANDER MEDICS ST
FORT BLISS, TX 79906-5327
Phone number: 915-742-0576
Copy
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