NPI 1518419498

Matthew Johnson

Organisation Supports Brokerage Agency Virginia Beach, VA

Practice location

Address: 1305 Meadow Lake Rd, Virginia Beach, VA 23454-2069
Phone: (757) 481-6252

Authorised official

Name: Matthew Ellis Johnson
Title: President
Phone: (757) 481-6252

Registered specialties

Supports Brokerage Agency Primary

Agencies Taxonomy 251X00000X Licence 942091 (VA)

Other Supports Brokerage providers in Virginia →

Registry record

NPI: 1518419498
Entity type: Organization
NPI issued: 26 Oct 2016
Record last updated: 26 Oct 2016

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.