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Individual

MR. MICHAEL ROBERT JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
3500 CENTRAL AVE, LAKE STATION, IN 46405-2271
(219) 963-7355
(219) 963-1562
Mailing address
3500 CENTRAL AVE, LAKE STATION, IN 46405-2271
(219) 963-7355
(219) 963-1562

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26019585A
IN

Other

Enumeration date
01/05/2011
Last updated
10/01/2025
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