Individual
ALEXANDRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
544 MANSFIELD LN, COLUMBIA, SC 29203-9098
(803) 569-0641
Mailing address
544 MANSFIELD LN, COLUMBIA, SC 29203-9098
(803) 569-0641
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
HCP-0697
SC
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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