Individual
MS. SUNDRA RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1414 26TH ST, 1414 26TH STREET, TUSCALOOSA, AL 35401-6642
(205) 752-6081
Mailing address
1414 26TH ST, 1414 26TH STREET, TUSCALOOSA, AL 35401-6642
(205) 752-6081
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
102375
AL
172V00000X
Community Health Worker
—
—
Other
Enumeration date
06/06/2008
Last updated
06/06/2008
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