Individual
JOHNSON WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 S NEW BALLAS RD STE 112A, CREVE COEUR, MO 63141-8252
(314) 251-6339
Mailing address
621 S NEW BALLAS RD STE 112A, CREVE COEUR, MO 63141-8252
(314) 251-6339
(314) 251-4564
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019012319
MO
Other
Enumeration date
04/14/2016
Last updated
08/05/2019
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