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Individual

JESSICA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-3364
(215) 590-1719
Mailing address
3401 CIVIC CENTER BLVD, SUITE M975, PHILADELPHIA, PA 19104-3364

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
OS022790
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/23/2018
Last updated
10/04/2023
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