Individual
MR. ANTUAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 MADISON AVE STE 300, TOLEDO, OH 43604-1257
(567) 312-8700
Mailing address
500 MADISON AVE STE 300, TOLEDO, OH 43604-1257
(419) 297-8551
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0220883
—
OH
Enumeration date
09/21/2018
Last updated
09/21/2018
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