Individual
MR. ANTOINE LEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11201 SHAKER BLVD STE 308, CLEVELAND, OH 44104-3871
(216) 417-8133
Mailing address
5520 TURNEY RD, GARFIELD HTS, OH 44125-3702
(216) 647-7026
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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