Jay De Vera

NPI #1366870347 in Clinton, North Carolina

Provider Information

NPI Number: 1366870347
Entity Type: Individual
Name: Jay De Vera
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Oct 29, 2013
Last Updated: Oct 29, 2013

Practice Location

Address: 417 W ELIZABETH ST APT A
City: Clinton
State: North Carolina
ZIP Code: 28328-4465
Phone: (443) 562-7065

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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