Individual
MR. BRADEN A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
2D RECONNAISSANCE BATTALION, CAMP LEJEUNE, NC 28542-0138
(910) 440-7703
Mailing address
2ND RECONNISANCE BATTALION PSC BOX 20138, CAMP LEJEUNE, NC 28542-0138
(910) 440-7703
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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