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1376015222
ANTHONY JOHNSON
MONCKS CORNER, SC
NPI
1376015222
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: SC 173)
Enumeration Date
2018-12-17
Last Update Date
2018-12-17
Business Address
ANTHONY JOHNSON
306 AIRPORT DRIVE
MONCKS CORNER, SC 29461
Phone number: 843-761-8272
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Mailing Address
ANTHONY JOHNSON
306 AIRPORT DR
MONCKS CORNER, SC 29461-2629
Phone number:
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