Individual
KIMBERLY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 STERLING PL, BROOKLYN, NY 11213-2606
(347) 546-8100
Mailing address
5370 CAMPBELLTON FAIRBURN RD STE 210, FAIRBURN, GA 30213-0019
(347) 546-8100
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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