Individual
MASON GRANT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 ROSE STREET MN 150, LEXINGTON, KY 40506-0001
(859) 323-5261
Mailing address
2492 OGDEN WAY, LEXINGTON, KY 40509-8575
(606) 213-3034
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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