Individual
MR. KENT GOULDING JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1414 MAIN ST, CANON CITY, CO 81212-3906
(719) 275-5221
Mailing address
11 KESTREL CT, CANON CITY, CO 81212-2777
(719) 275-7739
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10006
CO
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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