Individual
MRS. MARTINIS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
914 N 9TH ST, DEKALB, IL 60115-2508
(815) 501-1483
Mailing address
914 N 9TH ST, DEKALB, IL 60115-2508
(815) 501-1483
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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