Individual
MRS. KIMBERLY WADDELL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 C ST, NORTH WILKESBORO, NC 28659-4145
(336) 667-5111
Mailing address
4230 NC HIGHWAY 18 S, MORAVIAN FALLS, NC 28654-9833
(336) 921-3361
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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