Most Relevant Information
Provider Data
| NPI Number: | 1003441627 |
| Provider Name: | TERRELL JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/04/2020 |
| Last Updated: | 03/04/2020 |
Provider Practice Location
201 NE 50TH ST
OKLAHOMA CITY
OK
731051811
Practice Location Phone/Fax
| Phone: | 4052357537 |
| Fax: |
Provider Mailing Location
11813 SW 15TH WAY
YUKON
OK
730999772
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |