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Individual

JOSEPH SUMMERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SOIDC

Contact information

Practice address
310 REGULUS AVE, DAM NECK ANNEX, VA 23451-5584
(231) 620-2831
Mailing address
440 FIELDSTONE GLEN WAY, VIRGINIA BEACH, VA 23454-5143
(231) 620-2831

Taxonomy

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

Other

Enumeration date
11/13/2020
Last updated
04/16/2024
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