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Individual

MR. OTHEA C, WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
285 BROOKSTONE WAY, JACKSONVILLE, NC 28546-9538
(910) 451-4041
Mailing address
285 BROOKSTONE WAY, JACKSONVILLE, NC 28546-9538
(910) 451-4041

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
04/13/2012
Last updated
04/13/2012
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