Ada Johnson
Exclusive Provider Organization in Yadkinville, NC. Individual provider (NPI-1).
NPI number1013239151
StatusActive
Last updated in NPPESFeb 16, 2010
Details
- NPI
- 1013239151
- Entity type
- Individual (NPI-1)
- Name
- Ada Johnson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 16, 2010
- Last updated
- Feb 16, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | 2883 | NC | Yes |
Practice location
903 W Main StYadkinville, NC 27055-7807
Phone 336-463-5510
Mailing address
8045 Peak RdClemmons, NC 27012-9789
Phone 336-463-5510
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