Individual
MR. XAVIER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NCTMB, CMT, CMMT
Contact information
Practice address
362 LEE ST, FOREST PARK, GA 30297-2442
(877) 287-9664
(877) 287-9664
Mailing address
PO BOX 827, ELLENWOOD, GA 30294-0827
(877) 287-9664
(877) 287-9664
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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