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Jacob Johnson, SOIDC

NPI 1588273999 · on the registry since 2020 · sole proprietor

Practice

Address
413 Salvo Ct
Holly Ridge, NC 28445
Phone
(573) 201-6504
Clinicians at this address
2

Registry record

Primary taxonomy
1710I1002X
1710I1002X
Sex
Male
Record last updated
2020-07-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina