Jacob Johnson, SOIDC
Jacob Johnson, SOIDC is an Independent Duty Corpsman in Holly Ridge, North Carolina. Practices as a sole proprietor. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
413 Salvo CtHolly Ridge, NC 28445-8609
Phone: (573) 201-6504
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Duty Corpsman (primary) | Taxonomy 1710I1002X |
|---|
Record details
| NPI number | 1588273999 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | SOIDC |
| Sole proprietor | Yes |
| NPI enumerated | July 31, 2020 |
| Last updated in NPPES | July 31, 2020 |
| Certification date | July 31, 2020 |
| Mailing address | 413 Salvo Ct, Holly Ridge, NC 28445-8609 |
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