Individual
TABITHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3215 MARTIN LUTHER KING JR BLVD, SUITE O, ANDERSON, SC 29625-1715
(864) 540-8404
(864) 540-8406
Mailing address
3212 MARTIN LUTHER KING JR BOULEVARD, SUITE O, ANDERSON, SC 29625
(864) 540-8404
(864) 540-8406
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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