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Individual

HEATHER JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
990 W ANN ARBOR TRL, PLYMOUTH, MI 48170-6204
(734) 414-1099
(734) 414-1065
Mailing address
990 W ANN ARBOR TRL, PLYMOUTH, MI 48170-6204
(734) 414-1099
(734) 414-1065

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601004334
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5601004334
LICENSE
MI
Enumeration date
05/09/2007
Last updated
07/08/2007
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