Most Relevant Information
Provider Data
| NPI Number: | 1003417957 |
| Provider Name: | MICHELLE JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/06/2020 |
| Last Updated: | 11/06/2020 |
Provider Practice Location
652 MAIN ST
BARBOURSVILLE
WV
255041439
Practice Location Phone/Fax
| Phone: | 3043020707 |
| Fax: |
Provider Mailing Location
652 MAIN ST
BARBOURSVILLE
WV
255041439
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |