Individual
MICAH GELANI JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 ALGOMA BLVD, OSHKOSH, WI 54901-3551
(920) 424-1234
Mailing address
6408 BRIDGE RD APT 242, MONONA, WI 53713-1832
(908) 229-8633
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
264928-30
WI
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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