| NPI | 1093965212 |
|---|---|
| Doing Business As | TERESA KAY JOHNSON MD |
| Entity Type | Organization |
| Authorized Contact | TERESA KAY JOHNSON Sole Owner 208-529-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ID M8742) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2024-10-14 |