Individual
QUINTON DEIONITE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 PINE ST APT 907, SAINT LOUIS, MO 63103-2371
(314) 783-6403
Mailing address
1600 PINE ST APT 907, SAINT LOUIS, MO 63103-2371
(314) 783-6403
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2021012926
MO
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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