Individual
DALLAS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
936 GARDNER RD, FOUR OAKS, NC 27524-8681
(919) 796-2527
Mailing address
936 GARDNER RD, FOUR OAKS, NC 27524-8681
(919) 796-2527
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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