Jacob Johnson, SOIDC
NPI #1588273999 in Holly Ridge, North Carolina
Provider Information
- NPI Number
- 1588273999
- Entity Type
- Individual
- Name
- Jacob Johnson, SOIDC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Military Health Care Provider - Independent Duty Corpsman
- Credential
- SOIDC
- Enumeration Date
- Jul 31, 2020
- Last Updated
- Jul 31, 2020
Practice Location
- Address
- 413 SALVO CT
- City
- Holly Ridge
- State
- North Carolina
- ZIP Code
- 28445-8609
- Phone
- (573) 201-6504
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman |
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