Individual
MRS. MARY MILLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1784 ELKAHATCHEE RD, ALEX CITY, AL 35010-4800
(256) 329-0868
(256) 329-1101
Mailing address
1784 ELKAHATCHEE RD, ALEX CITY, AL 35010-4800
(256) 329-0868
(256) 329-1101
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
0299
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0299
OT ALABAMA LIC.
AL
Enumeration date
10/17/2007
Last updated
10/17/2007
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