Individual
BRIAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2940 WAKEFIELD CT, HEPHZIBAH, GA 30815-6542
(706) 449-2880
(706) 793-0411
Mailing address
2940 WAKEFIELD CT, HEPHZIBAH, GA 30815-6542
(706) 449-2880
(706) 793-0411
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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