MR. Brent Johnson, PTA

NPI #1306233283 in Chesapeake, Virginia

Provider Information

NPI Number: 1306233283
Entity Type: Individual
Name: MR. Brent Johnson, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Credential: PTA
Enumeration Date: Apr 18, 2015
Last Updated: Jan 28, 2016

Practice Location

Address: 404 CAYLAND CT
City: Chesapeake
State: Virginia
ZIP Code: 23322-3624
Phone: (757) 482-4013

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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