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1124477658
JOHNATHAN ANTONIO BRUNSON
WILSON, NC
NPI
1124477658
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-06-06
Last Update Date
2020-08-04
Business Address
JOHNATHAN ANTONIO BRUNSON LCAS-A
3011 NC HIGHWAY 42 W SUITE G
WILSON, NC 27893
Phone number: 252-991-3985
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Mailing Address
JOHNATHAN ANTONIO BRUNSON LCAS-A
307 BEECH ST
GOLDSBORO, NC 27530-2818
Phone number: 919-731-2119
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