Individual
MR. JERRY CHRISTOPHER TOWNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 ANTIQUE CT, FAYETTEVILLE, NC 28312-9351
(910) 797-9053
Mailing address
113 ANTIQUE CT, FAYETTEVILLE, NC 28312-9351
(910) 797-9053
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
21171
NC
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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