Individual
JEANNE RAE JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
6300 MADDOX BLVD, CHINCOTEAGUE, VA 23336-2617
(757) 336-3115
(757) 336-1947
Mailing address
6255 HIGHLAND PARK DR, CHINCOTEAGUE, VA 23336-2215
(757) 336-6279
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230000643
VA
Other
Enumeration date
09/19/2005
Last updated
07/08/2007
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