Individual
LONNIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 WOODLAND AVE SE, MASSILLON, OH 44646-8167
(330) 323-3592
Mailing address
1401 WOODLAND AVE SE, MASSILLON, OH 44646-8167
(330) 323-3592
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400256940603
OH
Other
Enumeration date
12/05/2021
Last updated
12/05/2021
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