| Antwone Johnson Sr, LPN | |
|
9605 Grand River Ave, Detroit, MI 48204-2139 | |
| (313) 834-5930 | |
| Not Available |
| Full Name | Antwone Johnson Sr |
|---|---|
| Gender | Male |
| Speciality | Licensed Practical Nurse |
| Location | 9605 Grand River Ave, Detroit, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558604801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 4703110366 (Michigan) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Antwone Johnson Sr, LPN 3851 Mcclellan St, Detroit, MI 48214-1311 Ph: (313) 829-2557 | Antwone Johnson Sr, LPN 9605 Grand River Ave, Detroit, MI 48204-2139 Ph: (313) 834-5930 |
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