Individual
CONSTANCE S JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2817 WHITTIER AVE, DAYTON, OH 45420-2655
(937) 732-5250
Mailing address
2817 WHITTIER AVE, DAYTON, OH 45420-2655
(937) 732-5250
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
M5707668
OH
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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