Individual
ALEXIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
394 BOSTWICK RD, PHELPS, NY 14532-9309
(315) 759-4166
Mailing address
394 BOSTWICK RD, PHELPS, NY 14532-9309
(315) 759-4166
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
320357
NY
Other
Enumeration date
02/10/2016
Last updated
02/10/2016
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