Individual
JERMAINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 HAYES AVE, ELYRIA, OH 44035-3534
(440) 420-6942
Mailing address
120 HAYES AVE, ELYRIA, OH 44035-3534
(440) 420-6942
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.005566
OH
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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