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Individual

DOMINICK CIAMPO

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
2D MARINE RAIDER BATTALION PSC BOX 20183, CAMP LEJEUNE, NC 28542

Taxonomy

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

Other

Enumeration date
01/29/2020
Last updated
11/27/2023
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