Individual
RISSA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 SOUTH GIN ROAD, ATOKA, OK 74525
(580) 889-3399
(580) 889-3887
Mailing address
PO BOX 346, WAPANUCKA, OK 73461-0346
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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