Individual
MRS. AMANDA FAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
33234 WILLOW RD, NEW BOSTON, MI 48164-9540
(734) 778-4808
Mailing address
33234 WILLOW RD, NEW BOSTON, MI 48164-9540
(734) 778-4808
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
L475986
MI
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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