DANE J TACKITT

HILL AFB, UT
NPI1366672750
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date2009-07-20
Last Update Date2009-07-20
Business Address
-- DANE J TACKITT IDMT
7338 LONCKI ST
HILL AFB, UT 84056-7300
Phone number: 801-777-4710
Mailing Address
-- DANE J TACKITT IDMT
7338 LONCKI ST
HILL AFB, UT 84056-7300
Phone number: