Individual
LATIESE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
16450 W VAN BUREN ST APT 2017, GOODYEAR, AZ 85338-1609
(313) 482-8185
Mailing address
16450 W VAN BUREN ST APT 2017, GOODYEAR, AZ 85338-1609
(313) 482-8185
Taxonomy
Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
011925
AZ
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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