Individual
CHARLOTTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
113 S LAFAYETTE BLVD, WARREN, MI 48091-2208
(313) 740-5750
Mailing address
113 S LAFAYETTE BLVD, WARREN, MI 48091-2208
(313) 740-5750
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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