Individual
KISZY SHENEA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6725 AMSTERDAM WAY, WILMINGTON, NC 28405-3778
(910) 471-5633
Mailing address
6725 AMSTERDAM WAY, WILMINGTON, NC 28405-3778
(910) 471-5633
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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