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Individual

MANITA YVETTE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3125 EASTWAY DR, SUITE 213, CHARLOTTE, NC 28205-5643
(704) 621-2201
(704) 900-6140
Mailing address
3125 EASTWAY DR, SUITE 213, CHARLOTTE, NC 28205-5643
(704) 621-2201
(704) 900-6140

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
NC

Other

Enumeration date
09/02/2009
Last updated
09/02/2009
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