NPI 1548826308
Jonathan David Brusherd, SOIDC
Practice location
- Address
- 710 Summit Loop, Rogers, AR 72756-3040
- Phone
- (479) 644-7775
- Mailing address
- 304 Sea Hunter Way, Sneads Ferry, NC 28460-6012
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1548826308
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 16 May 2019
- Record last updated
- 16 May 2019
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.