Individual
LAJUANNA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1602 BEL AIR CIR, DOUGLAS, GA 31533-1396
(912) 592-0661
Mailing address
1602 BEL AIR CIR, DOUGLAS, GA 31533-1396
(912) 592-0661
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
07/21/2022
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