Individual
MR. TYRONE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 CHESTER AVE STE 300, PHILADELPHIA, PA 19104-4880
(215) 769-3561
(215) 769-3860
Mailing address
4100 CHESTER AVE STE 300, PHILADELPHIA, PA 19104-4880
(215) 769-3561
(215) 769-3860
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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