Individual
JOHNATHON T BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
100 WHITE ST, JACKSONVILLE, NC 28540
(910) 449-5064
Mailing address
100 WHITE ST, JACKSONVILLE, NC 28540
(910) 449-5064
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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