Individual
VICTOR DESANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
A-66 SNEAD'S FERRY RD, CAMP LEJEUNE, NC 28542-0183
(910) 440-7704
Mailing address
150 CORNEL LN, HAMPSTEAD, NC 28443
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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