Individual
DIANNA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 S MARGENE DR, MIDWEST CITY, OK 73130-4219
(405) 255-6201
Mailing address
206 S MARGENE DR, MIDWEST CITY, OK 73130-4219
(405) 255-6201
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/28/2017
Last updated
04/28/2017
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