Individual
BRIAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1163 BRIDGE MILL AVE, CANTON, GA 30114-7713
(770) 845-6027
Mailing address
1163 BRIDGE MILL AVE, CANTON, GA 30114-7713
(770) 845-6027
Taxonomy
Speciality
Code
Description
License number
State
246W00000X
Cardiology Technician
Primary
00015619
GA
Other
Enumeration date
09/25/2015
Last updated
09/25/2015
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