Individual
MR. EDWIN SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
COMBAT LOGISTICS REGIMENT 27, 2D MARINE LOGISTICS GROUP, PSC BOX 20125, CAMP LEJEUNE, NC 28542-0125
(910) 450-6673
Mailing address
1003 PINE VALLEY RD, JACKSONVILLE, NC 28546-1647
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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