Individual
CHRISTOPHER CLARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2448 HIGHWAY 411 SE, FAIRMOUNT, GA 30139-2914
(706) 263-0039
Mailing address
2448 HIGHWAY 411 SE, FAIRMOUNT, GA 30139-2914
(706) 263-0039
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
057957208
GA
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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