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Individual

MONICA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3278 MITCHELL BLVD, MOODY A F B, GA 31699-1500
(229) 527-2105
(229) 257-3113
Mailing address
6004 SUSAN CIR APT A, VALDOSTA, GA 31605-5282

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
06/02/2009
Last updated
06/02/2009
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