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Individual
KEITH LELAND JOHNSON
Active
Individual
KEITH LELAND JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13546
NC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/04/2023
Last updated
09/07/2023
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