Individual
MATRINA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
713 ALABAMA AVE, CLEWISTON, FL 33440-5586
(863) 677-6031
Mailing address
713 ALABAMA AVE, CLEWISTON, FL 33440-5586
(863) 677-6031
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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