Individual
MR. RICKY WILLIAM BRETTHAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1853 OCONNELL BLVD, BLDG 1042, FT CARSON, CO 80913-4055
(719) 524-4670
Mailing address
5510 WHISKEY RIVER DR, COLORADO SPRINGS, CO 80922-4110
(719) 550-9196
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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