CHADDRICK LENDON JACK

CORPUS CHRISTI, TX
NPI1922068246
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: TX  1710I1002X)
Enumeration Date2006-03-23
Last Update Date2008-02-06
Business Address
Mr. CHADDRICK LENDON JACK
10651 E ST
CORPUS CHRISTI, TX 78419-5130
Phone number: 361-961-2688
Mailing Address
Mr. CHADDRICK LENDON JACK
10651 E ST
CORPUS CHRISTI, TX 78419-5130
Phone number: 361-961-2688
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