Individual
MRS. JENNIFER SUE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 FEDERAL AVE NW, MASSILLON, OH 44647-5469
(330) 833-1091
Mailing address
220 FEDERAL AVE NW, MASSILLON, OH 44647-5469
(330) 833-1091
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
S13138
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8957884
—
OH
Enumeration date
04/13/2018
Last updated
06/16/2018
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