Individual
KWEZETA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4150 ARKWRIGHT RD APT 79, MACON, GA 31210-1727
(478) 258-5618
Mailing address
4150 ARKWRIGHT RD APT 79, MACON, GA 31210-1727
(478) 258-5618
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
GA
172A00000X
Driver
—
—
332100000X
Department of Veterans Affairs (VA) Pharmacy
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/07/2023
Last updated
04/21/2023
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