Individual
AMIE KRYSTRINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
290 CONGRESS ST, PORTLAND, ME 04101-3684
(207) 774-0344
Mailing address
36B WATER ST, GORHAM, ME 04038-1020
(207) 251-6686
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR12944
ME
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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