Individual
ERIC LEE WOODWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
A66 BOAT BASIN ROAD, CAMP LEJEUNE, NC 28542
(910) 440-7714
Mailing address
120A JAMES AVE, HOLLY RIDGE, NC 28445-7037
(714) 474-7079
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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