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1336116003
GARY LYNN JOHNSON
SOUTH CHARLESTON, WV
NPI
1336116003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WV 01092)
Enumeration Date
2006-03-02
Last Update Date
2007-12-17
Business Address
-- GARY LYNN JOHNSON PA
610 CHESTNUT ST
SOUTH CHARLESTON, WV 25309-1251
Phone number: 304-766-7515
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Mailing Address
-- GARY LYNN JOHNSON PA
107 ROCKY STEP RD
SCOTT DEPOT, WV 25560-9631
Phone number: 304-412-4243
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