Individual
KELLY OWENS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
479 BYPASS 72 NW STE 100, GREENWOOD, SC 29649-1484
(864) 223-8909
Mailing address
419 STONEWOOD DR, GREENWOOD, SC 29649-9709
(803) 240-8131
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
37233
SC
Other
Enumeration date
07/27/2017
Last updated
04/12/2018
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