Individual
CHARLES J DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 COBBLESTONE DR, CREEDMOOR, NC 27522-7355
(804) 621-9119
Mailing address
1740 COBBLESTONE DR, CREEDMOOR, NC 27522-7355
(804) 621-9119
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
NC
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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