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Individual

MR. NATHANIEL JAMES JOHNSTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, MA

Contact information

Practice address
14556 EDGEMERE DR, SPRING HILL, FL 34609-0684
(352) 942-0454
Mailing address
1009 MAITLAND CENTER COMMONS BLVD STE 212, MAITLAND, FL 32751-7270

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008332900
FL
Enumeration date
08/22/2017
Last updated
08/23/2017
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