Individual
KIMBERLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 MARCIA LOUISE DR, SOUTHAVEN, MS 38672-6750
(901) 661-0159
Mailing address
3030 MARCIA LOUISE DR, SOUTHAVEN, MS 38672-6750
(901) 661-0159
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
About Stedi
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