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1689920985
JONATHAN BLAKELY BRUGGE
SOUTH PASADENA, CA
NPI
1689920985
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2012-07-24
Last Update Date
2012-09-19
Business Address
Mr. JONATHAN BLAKELY BRUGGE BASW CADCA
616 PROSPECT AVE APT 2
SOUTH PASADENA, CA 91030-2433
Phone number: 323-770-2345
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Mailing Address
Mr. JONATHAN BLAKELY BRUGGE BASW CADCA
616 PROSPECT AVE APT 2
SOUTH PASADENA, CA 91030-2433
Phone number: 323-770-2345
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