Individual
VERNON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
15105 ARCHELON WAY, WOODBRIDGE, VA 22193-5815
(571) 991-1087
Mailing address
15105 ARCHELON WAY, WOODBRIDGE, VA 22193-5815
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000388
VA
Other
Enumeration date
01/12/2013
Last updated
01/12/2013
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