Individual
MARCUS L JOHNSON I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2995 WARRIOR LN, POPLAR BLUFF, MO 63901-8600
(573) 712-2902
Mailing address
2995 WARRIOR LN, POPLAR BLUFF, MO 63901-8600
(573) 712-2902
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
T981128620
MO
Other
Enumeration date
04/16/2024
Last updated
03/12/2025
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