NPI 1306233283

Brent Johnson, PTA

Practitioner Contractor Chesapeake, VA

Practice location

Address: 404 Cayland CT, Chesapeake, VA 23322-3624
Phone: (757) 482-4013

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence PTA 23821 (FL)

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Registry record

NPI: 1306233283
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Apr 2015
Record last updated: 28 Jan 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.