Individual
EARL DEAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7206 STONE CROSSING DR, FREDERICKSBURG, VA 22407-7359
(540) 841-3346
Mailing address
7206 STONE CROSSING DR, FREDERICKSBURG, VA 22407-7359
(540) 841-3346
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
2705113047
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2705113047
—
VA
Enumeration date
04/05/2018
Last updated
04/05/2018
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