Individual
MA'KAIYLA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1668 WOODMAYR DR, WATERLOO, IA 50703-1358
(319) 529-0536
Mailing address
1668 WOODMAYR DR, WATERLOO, IA 50703-1358
(319) 529-0536
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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