BRANDON TYLER RIEDEL

PORTLAND, OR
NPI1730785296
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  2000032988)
Enumeration Date2020-12-09
Last Update Date2020-12-09
Business Address
BRANDON TYLER RIEDEL ATC
2219 SE 68TH AVE
PORTLAND, OR 97215-4026
Phone number: 503-517-1063
Mailing Address
BRANDON TYLER RIEDEL ATC
1007 S COLLEGE ST
NEWBERG, OR 97132-3366
Phone number: 815-579-9454