Provider Demographics
NPI:1558004820
Name:BRELAND, CHANDLER AUSTIN (EMT, IDMT, BLS, ALS)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:AUSTIN
Last Name:BRELAND
Suffix:
Gender:M
Credentials:EMT, IDMT, BLS, ALS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 FISHER ST
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39534-2508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 STETSON LN
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-4768
Practice Address - Country:US
Practice Address - Phone:360-984-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians