Organization
JOHNSON I-CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN LEE JOHNSON OD (CHIEF MANAGER)
(615) 497-5512
Entity
Organization
Contact information
Practice address
1024 GLENBROOK WAY, HENDERSONVILLE, TN 37075-1230
(615) 822-8464
(615) 822-8465
Mailing address
1024 GLENBROOK WAY, HENDERSONVILLE, TN 37075-1230
(615) 822-8464
(615) 822-8465
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TN2419
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q022814
—
TN
Enumeration date
07/12/2016
Last updated
09/15/2016
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