Individual
MR. JAMAAL CARLOS JOHNSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
706 KING RD STE F, RIVERDALE, GA 30274-2034
(877) 285-1780
Mailing address
810 WILLOW BEND DR, JONESBORO, GA 30238-5956
(404) 702-0961
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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