NPI 1376960179

Joseph Durant, LMTBA

Practitioner Specialist Brunswick, GA

Practice location

Address: 1111 Glynco Pkwy STE. 400, Brunswick, GA 31525-7921
Phone: (912) 269-4534
Mailing address: 107 Mackay Cir, Brunswick, GA 31525-4525

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence MT003512 (GA)

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Registry record

NPI: 1376960179
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Mar 2014
Record last updated: 19 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.