Individual
MARK ROBERT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
936 E LUDINGTON AVE, LUDINGTON, MI 49431-2438
(231) 845-7332
(213) 845-8674
Mailing address
2688 N SHERMAN RD, LUDINGTON, MI 49431-9598
(231) 843-1975
(231) 845-8674
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302023036
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302023036
PHARMACIST
MI
Enumeration date
04/23/2008
Last updated
04/23/2008
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