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Individual

DR. MONICA JOHNSONBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
17135 KERCHEVAL AVE, GROSSE POINTE, MI 48230-1660
(313) 473-9339
(313) 406-7254
Mailing address
PO BOX 617, ROSEVILLE, MI 48066-0617
(317) 374-2225

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
18003575A
IN
152W00000X
Optometrist
Primary
4901004540
MI
152W00000X
Optometrist
5842
OH

Other

Enumeration date
07/10/2009
Last updated
10/14/2020
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