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1427666700
BRYAN VILLELA
CAMP LEJEUNE, NC
NPI
1427666700
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2020-07-22
Last Update Date
2020-07-22
Business Address
BRYAN VILLELA SOIDC
2D MARINE RAIDER BATTALION
CAMP LEJEUNE, NC 28540
Phone number: 910-440-7704
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Mailing Address
BRYAN VILLELA SOIDC
206 PINE ISLAND DR
HAMPSTEAD, NC 28443-6500
Phone number: 347-850-5560
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