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1689367682
BRIAN DERTLI
POMONA, CA
NPI
1689367682
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-05-26
Last Update Date
2023-05-26
Business Address
BRIAN DERTLI
309 E 2ND ST
POMONA, CA 91766-1854
Phone number: 909-469-5589
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Mailing Address
BRIAN DERTLI
309 E 2ND ST
POMONA, CA 91766-1854
Phone number: 909-469-5589
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