Individual
MR. CHASE CHESTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 W DL INGRAM AVE, CANNON AFB, NM 88103-5103
(575) 904-3917
(575) 784-6028
Mailing address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 W DL INGRAM AVE, CANNON AFB, NM 88103-5103
(575) 904-3917
(575) 784-6028
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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