Individual
JENNIFER M JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
3774 BAYLEY DR, SUITE B, LAFAYETTE, IN 47905-8651
(765) 807-2280
(765) 807-2281
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 446-5317
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
123994
IN
Other
Enumeration date
08/05/2011
Last updated
08/05/2011
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