Individual
CHARLES DAVID JOHNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
555 RAILROAD ST, BANGOR, MI 49013-1464
(269) 427-6171
(866) 242-4929
Mailing address
4929 BRADEN ST, GRAND JUNCTION, MI 49056-9249
(269) 605-9103
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704265201
MO
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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