Individual
MISS MICHIKO WANATESHE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
190 BOWEN RD, STOCKBRIDGE, GA 30281-1812
(678) 939-8625
Mailing address
190 BOWEN RD, STOCKBRIDGE, GA 30281-1812
(678) 939-8625
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
863355445
GA
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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