Individual
CHADRIKA L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER, CENTER DIRECT
Contact information
Practice address
1800 ALBANY ST, BRUNSWICK, GA 31520-5901
(912) 571-7497
Mailing address
139 ALTAMA CONNECTOR UNIT 181, BRUNSWICK, GA 31525-1888
(912) 571-7497
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9125717497
N/A AT THIS TIME, CONTACT NUMBER
GA
Enumeration date
09/13/2020
Last updated
09/13/2020
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