Individual
MRS. AMBER RENEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC MMS
Contact information
Practice address
12255 DE PAUL DR, SUITE 460, BRIDGETON, MO 63044-2510
(314) 770-1844
(314) 770-1843
Mailing address
12255 DE PAUL DR, SUITE 460, BRIDGETON, MO 63044-2510
(314) 770-1844
(314) 770-1843
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2008026707
MO
Other
Enumeration date
04/02/2008
Last updated
09/16/2014
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