Individual
JESSICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
110 METROPLEX BLVD, SUITE H, PEARL, MS 39208-9210
(601) 664-1664
(601) 664-1661
Mailing address
110 METROPLEX BLVD, SUITE H, PEARL, MS 39208-9210
(601) 664-1664
(601) 664-1661
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T0122
MS
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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