Individual
ITZIA Y JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7839 ANTONIO LN, BLACKLICK, OH 43004-7005
(614) 284-4667
Mailing address
7839 ANTONIO LN, BLACKLICK, OH 43004-7005
(614) 284-4667
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
4505584
OH
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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