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Individual

DR. CRYSTAL R JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPH

Contact information

Practice address
3333 E SHELBY DR, MEMPHIS, TN 38105
(901) 794-3690
Mailing address
568 POPLAR AVE, MEMPHIS, TN 38105-4510
(901) 527-2411

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7123
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4442531
TN
Enumeration date
11/17/2011
Last updated
11/17/2011
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