Individual
CASSIDY BLAIRE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6780 MAYFIELD RD, MAYFIELD HEIGHTS, OH 44124-2203
(440) 449-4500
Mailing address
PO BOX 74647, CLEVELAND, OH 44194-4647
(440) 879-0081
(440) 879-0084
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50003589
OH
Other
Enumeration date
09/20/2012
Last updated
08/03/2015
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