MATTHEW DEFRIES

VIRGINIA BEACH, VA
NPI1710512009
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: IN  5060000751)
Enumeration Date2020-03-06
Last Update Date2023-06-22
Business Address
MATTHEW DEFRIES L02A
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461-1935
Phone number: 219-869-1039
Mailing Address
MATTHEW DEFRIES L02A
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461-1935
Phone number:
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