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Individual

STEPHEN OTTO JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1786 KINOOLE ST, HILO, HI 96720-5245
(808) 959-5855
Mailing address
1303 KINOOLE ST, HILO, HI 96720-4129
(501) 680-8545

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
11/09/2021
Last updated
11/09/2021
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