Individual
MARIE L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
2460 E MADRID AVE, SPRINGFIELD, MO 65804-1884
(417) 814-4040
Mailing address
1442 N PROSPECT AVE, SPRINGFIELD, MO 65802-2016
(201) 952-5628
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86084578
MO
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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