Individual
WESLEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8023 SHADY POND DR, CHARLOTTE, NC 28227-4650
(404) 807-4779
Mailing address
8023 SHADY POND DR, CHARLOTTE, NC 28227-4650
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
00122494
NC
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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