BRANDON LANE THIELE

SAN DIEGO, CA
NPI1881277192
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2021-05-04
Last Update Date2021-12-03
Business Address
BRANDON LANE THIELE IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number: 619-532-7968
Mailing Address
BRANDON LANE THIELE IDC
10004 LOS RANCHITOS RD
LAKESIDE, CA 92040-2724
Phone number: 360-689-2613