Individual
MRS. JESSICA LYN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3963 MAIDSTONE DR, GAHANNA, OH 43230-4513
(614) 316-8046
Mailing address
3963 MAIDSTONE DR, GAHANNA, OH 43230-4513
(614) 316-8046
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2905146
—
OH
Enumeration date
08/05/2014
Last updated
08/05/2014
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