Individual
AUTUMN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6903 BONNIE RIDGE DR, APT T1, BALTIMORE, MD 21209-5164
(443) 570-5726
Mailing address
6903 BONNIE RIDGE DR, APT T1, BALTIMORE, MD 21209-5164
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M04778
MD
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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