BRYAN JUDSON SMITH

SAN DIEGO, CA
NPI1457633711
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2011-09-13
Last Update Date2011-09-13
Business Address
Mr. BRYAN JUDSON SMITH Dive IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-532-6064
Mailing Address
Mr. BRYAN JUDSON SMITH Dive IDC
62468 HIGHWAY 49
LINEVILLE, AL 36266-4923
Phone number: 240-478-1870