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Individual

DR. TIFFANY J JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
9540 MANCHESTER RD, SAINT LOUIS, MO 63119-1313
(314) 962-3830
(314) 962-3909
Mailing address
40 E NORTH ST, EUREKA, MO 63025-1205
(636) 200-4393
(636) 938-2650

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2005025566
MO

Other

Enumeration date
02/23/2007
Last updated
11/18/2014
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