Individual
JUANITA PERDOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2406 BLUE RIDGE RD STE 205, RALEIGH, NC 27607-6666
(919) 782-4884
Mailing address
1001 MANCHESTER DR, RALEIGH, NC 27609-5152
(704) 839-9336
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12669
NC
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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