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Individual

DR. CYNTHIA G JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
2500 N MAYFAIR RD, WAUWATOSA, WI 53226-1409
(414) 771-8999
Mailing address
12000 W CARMEN AVE, MILWAUKEE, WI 53225-2116

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2246-035
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38576600
WI
Enumeration date
03/02/2007
Last updated
07/08/2007
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