Individual
COURTNY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
Mailing address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-2000
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
LPR00142
RI
Other
Enumeration date
07/23/2014
Last updated
12/16/2021
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