Individual
JEREMY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
403 MUNICIPAL DR, CARTERVILLE, IL 62918-2042
(855) 608-3560
(618) 956-9349
Mailing address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
(618) 937-1440
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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