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Individual
LAVON JOHNSON
Active
Individual
LAVON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
03/17/2014
Last updated
05/03/2022
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