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1649517921
FRED JOSEPH BRODIE
SAN DIEGO, CA
NPI
1649517921
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider Independent Duty Corpsman
Enumeration Date
2013-01-07
Last Update Date
2013-01-07
Business Address
MR. FRED JOSEPH BRODIE DIVE IDC
2930 TARAWA RD
SAN DIEGO, CA 92155-5198
Phone number: 619-437-5962
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Mailing Address
MR. FRED JOSEPH BRODIE DIVE IDC
2952 WELLINGTON ST
SAN DIEGO, CA 92111-5740
Phone number: 808-554-4533
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