Individual
KELLEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1856 THOMPSON BRIDGE RD, GAINESVILLE, GA 30501-1663
(770) 538-2786
Mailing address
2402 SARDIS CHASE CT, BUFORD, GA 30519-6023
(770) 710-9665
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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