Individual
MR. EZRA LAMONT JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
NAVAL HOSPITAL CAMP LEJEUNE, 100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547
(910) 450-4750
Mailing address
8 CARVER RD, JACKSONVILLE, NC 28540-7010
(910) 450-4750
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/07/2006
Last updated
07/08/2007
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