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1306526686
DEWAYNE JERRELL JOHNSON
FLORISSANT, MO
NPI
1306526686
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
246ZC0007X Specialist/Technologist, Other, Surgical Assistant
Enumeration Date
2023-07-20
Last Update Date
2023-07-20
Business Address
Ms. DEWAYNE JERRELL JOHNSON
1640 EMERALD CREEK DR
FLORISSANT, MO 63031-2046
Phone number: 314-283-2067
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Mailing Address
Ms. DEWAYNE JERRELL JOHNSON
1640 EMERALD CREEK DR
FLORISSANT, MO 63031-2046
Phone number: 314-283-2067
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