Individual
JASON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9400 MENTOR AVE, MENTOR, OH 44060-4520
(440) 255-6247
Mailing address
9400 MENTOR AVE, MENTOR, OH 44060-4520
(440) 255-6247
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03442412
OH
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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