Individual
TERRANCE RODERICK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
24110 ROSEWOOD ST, OAK PARK, MI 48237-2240
(248) 796-2662
Mailing address
24110 ROSEWOOD ST, OAK PARK, MI 48237-2240
(248) 796-2662
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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