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Individual

MRS. PATRICIA D JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PP

Contact information

Practice address
1341 W HILL AVE, VALDOSTA, GA 31601-5235
(229) 249-7730
Mailing address
156 PEACH AVE S, LEESBURG, GA 31763-3781
(407) 314-5159

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
09/14/2022
Last updated
09/14/2022
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