Individual
CHANTEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20953 UNIVERSAL AVE, EASTPOINTE, MI 48021-2930
(586) 443-9715
Mailing address
20953 UNIVERSAL AVE, EASTPOINTE, MI 48021-2930
(586) 443-9715
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113446
MI
Other
Enumeration date
01/04/2016
Last updated
01/04/2016
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