Individual
GRACE REBEKAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1537 S SCATTERFIELD RD, ANDERSON, IN 46016-5766
(765) 649-1200
Mailing address
1537 S SCATTERFIELD RD, ANDERSON, IN 46016-5766
(765) 649-1200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004655A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OH
Other
Enumeration date
10/20/2025
Last updated
06/10/2026
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