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Individual

MR. RAFE ANTHONY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1304 DENMARK CT, SLIDELL, LA 70461-4561
(678) 392-6081
Mailing address
1304 DENMARK CT, SLIDELL, LA 70461-4561
(678) 392-6081

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
007709423
LA
343900000X
Non-emergency Medical Transport (VAN)
Primary
82-1264661
LA

Other

Enumeration date
08/27/2021
Last updated
08/27/2021
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