Individual
GARY ANTHONY JOHNSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 DIGHTON CT, VIRGINIA BEACH, VA 23464-8624
(757) 202-6880
(757) 963-9092
Mailing address
1430 DIGHTON CT, VIRGINIA BEACH, VA 23464-8624
(757) 202-6880
(757) 963-9092
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
T67226422
VA
Other
Enumeration date
10/17/2010
Last updated
10/17/2010
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