Individual
MR. JOHN IAKOPO LEASIOLAGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2D RECONNAISSANCE BN, 2D MARDIV, PSC BOX 20138, CAMP LEJEUNE, NC 28542
(910) 440-7401
Mailing address
439 BELVEDERE DR, HOLLY RIDGE, NC 28445-7025
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
—
—
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/27/2012
Last updated
11/27/2012
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