JEFFREY ALLEN TICE

SAN DIEGO, CA
NPI1497977839
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2007-05-03
Last Update Date2007-07-08
Business Address
Mr. JEFFREY ALLEN TICE IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number: 619-532-5103
Mailing Address
Mr. JEFFREY ALLEN TICE IDC
8230 JORDAN ST
SAN DIEGO, CA 92123-2016
Phone number: 619-532-5103