Individual
JERROLD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6679 BALSAM DR, BEDFORD HEIGHTS, OH 44146-4804
(407) 450-4549
Mailing address
6679 BALSAM DR, BEDFORD HEIGHTS, OH 44146-4804
(407) 450-4549
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
OH
172A00000X
Driver
—
OH
374U00000X
Home Health Aide
—
OH
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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