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Individual

JOSE MIGUEL DE JESUS-CARRION

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
BLDG A-71 SNEADS FERRY RD., CAMP LEJEUNE, NC 28542-0138
(910) 440-7703
Mailing address
5-3845 COMBAT MEDIC DRIVE, FORT BRAGG, NC 28310-9610
(910) 394-1059

Taxonomy

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

Other

Enumeration date
05/24/2021
Last updated
08/29/2023
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