Individual
MICHELLE LYNNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIR LOSS
Contact information
Practice address
1891 RIVER ST, HYDE PARK, MA 02136-1418
(617) 333-7434
Mailing address
1891 RIVER ST, HYDE PARK, MA 02136-1418
(617) 333-7434
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
1097244
MA
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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