Individual
KRISTEN JOLLEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
629 BROAD ST, ELIZABETHTON, TN 37643-2221
(423) 543-7376
Mailing address
175 BOB FITZ RD, JOHNSON CITY, TN 37615-3442
(865) 712-7158
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3789
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2022
Last updated
12/01/2022
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