Individual
COURTNEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
421 W KING AVE APT 6, KINGSLAND, GA 31548-3203
(912) 464-5784
Mailing address
421 W KING AVE APT 6, KINGSLAND, GA 31548-3203
(912) 464-5784
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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