Individual
AMY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1654 S 5TH ST W, MISSOULA, MT 59801-2220
(406) 546-1749
Mailing address
1654 S 5TH ST W, MISSOULA, MT 59801-2220
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
604
MT
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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