Individual
SANDRA A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3847 PINE GROVE AVE, FORT GRATIOT, MI 48059-4265
(810) 984-2250
Mailing address
6645 BUNKER RD, BURTCHVILLE, MI 48059-2202
(810) 385-3221
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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