Individual
JUSTIN PEARCE-JORDAN LOUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3332 BRIDGES ST STE B, MOREHEAD CITY, NC 28557-3296
(252) 633-4461
Mailing address
PO BOX 890293, CHARLOTTE, NC 28289-0293
(866) 429-1213
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05521
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-05521
NC LICENSE
NC
Enumeration date
01/20/2015
Last updated
01/25/2022
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