LANCE BRYAN DEROSIER

FAIRCHILD AFB, WA
NPI1588333876
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date2021-09-09
Last Update Date2021-09-09
Business Address
LANCE BRYAN DEROSIER
300 N SHORT ST
FAIRCHILD AFB, WA 99011-9530
Phone number: 425-501-9301
Mailing Address
LANCE BRYAN DEROSIER
PSC 1 BOX 631
APO, AE 09009-0007
Phone number:
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