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Individual

BURTON LEROY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
700 FREDERICK BLVD, PORTSMOUTH, VA 23707-3314
(757) 391-9123
Mailing address
1800 TIMBERWOOD LN, VIRGINIA BEACH, VA 23454-2842
(757) 236-4260

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202009966
VA

Other

Enumeration date
01/05/2012
Last updated
01/05/2012
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