Individual
JIM M JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1464 CAROLINA AVENUE, ORANGEBURG, SC 29115-1464
(803) 534-1234
Mailing address
PO BOX 109, ORANGEBURG, SC 29116-0109
(803) 534-1234
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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