Individual
LESLIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6207 KAMER CT, CHARLESTOWN, IN 47111-9078
(502) 810-7026
Mailing address
6207 KAMER CT, CHARLESTOWN, IN 47111-9078
(502) 810-7026
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
KY
Other
Enumeration date
02/20/2021
Last updated
02/20/2021
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