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1881030310
BRANDON CHRISTOPHER JACKSON
SAN DIEGO, CA
NPI
1881030310
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2013-05-10
Last Update Date
2013-05-10
Business Address
-- BRANDON CHRISTOPHER JACKSON IDC
6810 CAMPHOR LN
SAN DIEGO, CA 92139
Phone number: 619-846-3392
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Mailing Address
-- BRANDON CHRISTOPHER JACKSON IDC
NMCB5
FPO, AP 96601-4961
Phone number: 619-846-3392
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