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1215364120
ZACHARY K JOHANNESEN
SAVANNAH, GA
NPI
1215364120
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 2578)
Enumeration Date
2013-10-09
Last Update Date
2013-10-09
Business Address
-- ZACHARY K JOHANNESEN
5353 REYNOLDS REYNOLDS STREET
SAVANNAH, GA 31405-6015
Phone number: 912-819-6172
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Mailing Address
-- ZACHARY K JOHANNESEN
255 W MICHIGAN AVE PO BOX 11223
JACKSON, MI 49201-2218
Phone number: 800-516-5315
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