Individual
CHASE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
718 MAGNOLIA DRIVE, TUSCALOOSA, AL 35487-0001
(727) 710-1523
Mailing address
11185 6TH STREET EAST, TREASURE ISLAND, FL 33706
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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