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Individual

MRS. JESSICA ANN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
UMT

Contact information

Practice address
314 GOFF MOUNTAIN ROAD, SUITE 13, CROSS LANES, WV 25313
(304) 776-5031
(304) 204-6332
Mailing address
314 GOFF MOUNTAIN RD., SUITE 13, CROSS LANES, WV 25313
(304) 776-5031
(304) 204-6332

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
2010-2725
WV
225700000X
Massage Therapist
Primary
593400-10
WV

Other

Enumeration date
10/06/2010
Last updated
10/06/2010
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