Individual
MRS. MARY JO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
510 BUTLER AVE, VETERANS AFFAIRS MEDICAL CENTER, MARTINSBURG, WV 25405
(304) 263-0811
(304) 262-7435
Mailing address
100 W. NORTH AVE, WINCHESTER, VA 22601
(540) 662-0754
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
716432
VA
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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