Individual
CONNIE S JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1029 WILD DOG PASS, DELRAY, WV 26714-4629
(304) 851-7497
Mailing address
1029 WILD DOG PASS # 10, DELRAY, WV 26714-4629
(304) 851-7497
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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