Individual
SAMANTHA VAN DYKE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13001 E 17TH PL, AURORA, CO 80045-2570
(575) 218-5936
Mailing address
282 QUARI ST, AURORA, CO 80011-8340
(912) 245-5510
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TL.0010600
CO
Other
Enumeration date
12/13/2024
Last updated
04/21/2025
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