Individual
AVERY JEROME HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
BUILDING HP217 F ST, BATTALION AID STATION 1ST BATTALION 2ND MARINES, CAMP LEJEUNE, NC 28542-0094
(910) 451-3607
Mailing address
202 SILKY CT, RICHLANDS, NC 28574-7418
(910) 787-6358
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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