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Individual

FANNY JERUSHA JOHNS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
420 COVERED VLG, BELDING, MI 48809-1665
(616) 430-2924
Mailing address
1785 PARK TRL NE, GRAND RAPIDS, MI 49525-7039
(616) 322-1713

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
06/10/2022
Last updated
06/10/2022
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