Individual
BRYAN ALAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
200 S PETTIGREW ST, RALEIGH, NC 27610-2651
(919) 341-8935
Mailing address
200 S PETTIGREW ST, RALEIGH, NC 27610-2651
(919) 341-8935
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PR37655
SC
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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