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Individual

DUSTIN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1825 MARIKA RD, FAIRBANKS, AK 99709-5521
(907) 474-0898
Mailing address
809 ORCA CT, FAIRBANKS, AK 99701-1408
(405) 982-2786

Taxonomy

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

Other

Enumeration date
11/16/2023
Last updated
11/16/2023
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