Individual
GLENDORA WHITLOW JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
423 HIGHWAY 466 APT 23203, LADY LAKE, FL 32159-6315
(352) 978-3003
Mailing address
423 HIGHWAY 466 APT 23203, LADY LAKE, FL 32159-6315
(352) 978-3003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16893
FL
Other
Enumeration date
03/02/2019
Last updated
03/02/2019
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