Individual
CRYSTAL K JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
894 E 223RD ST, EUCLID, OH 44123-3302
Mailing address
894 E 223RD ST, EUCLID, OH 44123-3302
(216) 924-3572
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1831467
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831467
DODD MPROVIDER
OH
Enumeration date
04/26/2020
Last updated
04/26/2020
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