1508948001

Everything you always wanted to know about MR. FRETZ BRUCE DAVID IDC 8425 2 MR. FRETZ BRUCE DAVID IDC 8425 but were afraid to ask.

MR. FRETZ BRUCE DAVID IDC 8425 2 MR. FRETZ BRUCE DAVID IDC 8425

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Name Prefix Provider Other Last Name Provider Other Middle Name Provider Other First Name Provider Other Credential
MR. FRETZ BRUCE DAVID IDC 8425 2 MR. FRETZ BRUCE DAVID IDC 8425
Gender:
Male
Enumeration date:
2006-10-20
Last update date:
2007-07-08
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
146L00000X Emergency Medical Technician, Paramedic none none

Phone Numbers

Type Number
Mailing Address Telephone Number 6195220807
Practice Location Address Telephone Number 6195564576

Addresses

Type Address City State Postal Country
Mailing Address 1212 LEYTE RD CORONADO CA 92118 CA
Practice Location Address USS MOBILE BAY CG 53 FPO US 0 US