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Individual

QIANA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
195 AARON CT, RIVERDALE, GA 30274-3601
(862) 241-2075
Mailing address
195 AARON CT, RIVERDALE, GA 30274-3601
(862) 241-2075

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary

Other

Enumeration date
05/02/2016
Last updated
05/02/2016
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