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Individual

JASON JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
97 W 22ND ST, HOLLAND, MI 49423-4771
(231) 683-8164
Mailing address
97 W 22ND ST, HOLLAND, MI 49423-4771
(231) 683-8164

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MI

Other

Enumeration date
07/26/2023
Last updated
07/26/2023
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