Individual
CHARLES MORSE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
595 BRIGHTON AVE, PORTLAND, ME 04102-2322
(207) 210-6700
(207) 899-3239
Mailing address
595 BRIGHTON AVE, PORTLAND, ME 04102-2322
(207) 210-6700
(207) 899-3239
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT1009
ME
Other
Enumeration date
05/15/2019
Last updated
06/27/2019
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