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Individual

MR. ROY ANTOINE TEAGUE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
807 SPRINGWOOD DR, JACKSONVILLE, NC 28546-9621
(972) 567-1630
Mailing address
807 SPRINGWOOD DR, JACKSONVILLE, NC 28546-9621
(972) 567-1630

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
04/10/2012
Last updated
04/10/2012
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