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Individual

ZACHERY COLE JOHANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
405 W GREENLAWN AVE STE 200, LANSING, MI 48910-2889
(248) 621-4792
Mailing address
2721 HANNAH BLVD APT 8012, EAST LANSING, MI 48823-6884
(319) 538-6186

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary

Other

Enumeration date
02/08/2021
Last updated
02/08/2021
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