Individual
VIC JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
145 CHERRY ST, MT CARMEL, TN 37645-3813
(423) 921-4424
Mailing address
145 CHERRY ST, MT CARMEL, TN 37645-3813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000209540
TN
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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