Individual
MARCUS 'MJ' JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 E FARGO ST, BROKEN ARROW, OK 74012-8881
(405) 651-1898
Mailing address
508 E FARGO ST, BROKEN ARROW, OK 74012-8881
(405) 651-1898
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/18/2013
Last updated
04/18/2013
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