Individual
VANITA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
4001 DANFORTH ROAD SW, ATLANTA, GA 30303
(330) 758-4515
(330) 758-5121
Mailing address
PO BOX 142014, FAYETTEVILLE, GA 30219
(404) 964-6325
(404) 745-8603
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD001019
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910342833A
—
GA
Enumeration date
04/03/2006
Last updated
05/05/2008
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