SearchVirginiaIndependent Duty Corpsman

Tyler Johnson, IDC

NPI 1679846281 · on the registry since 2012 · sole proprietor

Practice

Address
342 Dover Ct
Virginia Beach, VA 23454
Phone
(415) 672-2782

Registry record

Primary taxonomy
Independent Duty Corpsman
1710I1002X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2012-02-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia