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1164635520
SHANNON PATRICK JOHNSON
NORFOLK, VA
NPI
1164635520
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2007-05-08
Last Update Date
2007-07-08
Business Address
Mr. SHANNON PATRICK JOHNSON IDC
1004 HERMITAGE RD BLDG 2052
NORFOLK, VA 23521-5000
Phone number: 757-462-3178
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Mailing Address
Mr. SHANNON PATRICK JOHNSON IDC
1096 VALENCIA CT
VIRGINIA BEACH, VA 23454-6789
Phone number: 757-301-8921
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