Individual provider · NPI-1
Felicia Johnson
Technician/Technologist, Optician · Florissant, MO
NPI number1407205529
StatusActive
Last updated in NPPESJun 9, 2016
Details
- NPI
- 1407205529
- Entity type
- Individual (NPI-1)
- Name
- Felicia Johnson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 9, 2016
- Last updated
- Jun 9, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | – | MO | Yes |
Practice location
1764 Thunderbird AveFlorissant, MO 63033
Phone 314-274-8484 · Fax 314-274-8585
Mailing address
1764 Thunderbird AveFlorissant, MO 63033
Phone 314-274-8484 · Fax 314-274-8585
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