Most Relevant Information
Provider Data
| NPI Number: | 1003526575 |
| Provider Name: | EDWARD JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/25/2022 |
| Last Updated: | 11/25/2022 |
Provider Practice Location
5600 N RIVER RD STE 800
ROSEMONT
IL
600185166
Practice Location Phone/Fax
| Phone: | 8888774268 |
| Fax: |
Provider Mailing Location
3444 ALMOND GROVE DR
FLORENCE
SC
295018197
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |