Individual
BRYAN JOSEPH TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
4340 MAURY AVE, LONG BEACH, CA 90807-2537
(562) 270-6344
Mailing address
1114 JUNIPERO AVE, APT 8, LONG BEACH, CA 90804-3510
(562) 304-3780
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E098624
CA
Other
Enumeration date
04/28/2017
Last updated
04/28/2017
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