Individual
MR. MATTHEW BRANT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
1 PORTER SQ, CAMBRIDGE, MA 02140-1431
(617) 864-7005
(617) 864-3250
Mailing address
1 PORTER SQ, CAMBRIDGE, MA 02140-1431
(617) 864-7005
(617) 864-3250
Taxonomy
Speciality
Code
Description
License number
State
156FC0801X
Contact Lens Fitter
6429
MA
156FX1800X
Optician
Primary
6429
MA
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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