Matthew Defries, L02A
Matthew Defries, L02A is an Independent Duty Corpsman in Virginia Beach, Virginia. Licensed in Indiana. Registered with an NPI since 2020.
- Licensed in
- IN
- In the registry since
- 2020
Practice location Address checks out
472 Polaris St Bldg 586Virginia Beach, VA 23461-1935
Phone: (219) 869-1039
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Duty Corpsman (primary) | Taxonomy 1710I1002X · Licence 5060000751 (IN) |
|---|
Record details
| NPI number | 1710512009 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | L02A |
| Sole proprietor | No |
| NPI enumerated | March 6, 2020 |
| Last updated in NPPES | June 22, 2023 |
| Certification date | June 22, 2023 |
| Mailing address | 472 Polaris St Bldg 586, Virginia Beach, VA 23461-1935 |
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