Individual
DEMETRIS WILLETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2217 JOE DR, DILLON, SC 29536-6205
(803) 260-9603
Mailing address
PO BOX 2015, DILLON, SC 29536-7015
(803) 260-9603
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
0000
SC
Other
Enumeration date
01/09/2022
Last updated
01/09/2022
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