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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