Individual
GREGORY ANTHONY JOHANSING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 1/2 CHAVNER ST, GOLD HILL, OR 97525-9690
(909) 436-9030
Mailing address
530 1/2 CHAVNER ST, GOLD HILL, OR 97525-9690
(909) 436-9030
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
1001452
OR
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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