Individual
GILBERT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15800 FAIRMOUNT DR, DETROIT, MI 48205-1448
(313) 850-5205
Mailing address
15800 FAIRMOUNT DR, DETROIT, MI 48205-1448
(313) 850-5205
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
MI
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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