Mary L. Johnson, LPN, LMT
Specialist in Victor, NY. Individual provider (NPI-1).
NPI number1063533859
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1063533859
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Mary L. Johnson
- Credential
- LPN, LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 2, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 015362 | NY | Yes |
Practice location
5 Railroad StreetVictor, NY 14564
Phone 585-749-9645
Mailing address
5350 County Road 37Hemlock, NY 14466-9616
Phone 585-749-9645
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