Individual
BRADLEY SHANE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2D RECONNAISSANCE BN, CAMP LEJEUNE, NC 28542
(828) 638-1011
Mailing address
2D RECONNAISSANCE BN, PSC BOX 20138, FPO, AA 28542
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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