Individual
KELLY LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
379 N MAIN ST APT 309, MUNROE FALLS, OH 44262-1061
(234) 380-0048
Mailing address
379 N MAIN ST APT 309, MUNROE FALLS, OH 44262-1061
(234) 380-0048
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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