Individual
DANE G JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2021 LAKESHORE DR, CHARLESTON, SC 29412-2017
(703) 851-9556
Mailing address
2021 LAKESHORE DR, CHARLESTON, SC 29412-2017
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
11/16/2017
Last updated
11/16/2017
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