Individual
MR. JOHNNY KING III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, BSN, MPH, BC-APH
Contact information
Practice address
1061 HARMON AVENUE, STE 1D03, FORT STEWART, GA 31314-5674
(912) 435-5071
Mailing address
1061 HARMON AVENUE, STE 1D03, FORT STEWART, GA 31314-5674
(912) 435-5071
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN087034
LA
Other
Enumeration date
08/20/2009
Last updated
09/01/2010
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