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Individual

VICTORIA L JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CFH

Contact information

Practice address
18168 SPICEBUSH AVE, NAMPA, ID 83687-5003
(208) 467-1943
Mailing address
18168 SPICEBUSH AVE, NAMPA, ID 83687-5003
(208) 467-1943

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
30573
ID

Other

Enumeration date
10/05/2007
Last updated
10/05/2007
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