Individual
TIA NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
18230 E SILVER CREEK AVE RM 205, AURORA, CO 80011-9501
(720) 847-6486
Mailing address
9551 SADDLE SORE CIR, CASHION, OK 73016-9449
(405) 204-4474
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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