Individual
IEASHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 PRAIRIE AVE, KALAMAZOO, MI 49006-2267
(269) 343-9844
Mailing address
1115 PRAIRIE AVE, KALAMAZOO, MI 49006-2267
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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