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Individual

LILA L. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CHAIII-C

Contact information

Practice address
172 MAIN ST, SAND POINT, AK 99661
(907) 383-3151
Mailing address
434 NORTH MAIN ST, NELSON LAGOON, AK 99571
(907) 383-3151

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
12/05/2008
Last updated
12/05/2008
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