Individual
JACOB TESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
A66 BOAT BASIN RD, CAMP LEJEUNE, NC 28545
(910) 440-7925
Mailing address
A66 BOAT BASIN RD, CAMP LEJEUNE, NC 28545
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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