Individual
MR. TONY DEANDRE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
341 YELLOW RIVER LN, CONYERS, GA 30012-3637
(404) 933-6473
Mailing address
341 YELLOW RIVER LN, CONYERS, GA 30012-3637
(404) 933-6473
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001605
GA
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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