DALLAS DOMINIQUE JOHNSTON

GRAND RAPIDS, MI
NPI1386394898
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601011845)
Enumeration Date2022-03-27
Last Update Date2023-10-09
Business Address
DALLAS DOMINIQUE JOHNSTON PA
100 MICHIGAN ST NE # MC019
GRAND RAPIDS, MI 49503-2560
Phone number: 616-486-0310
Mailing Address
DALLAS DOMINIQUE JOHNSTON PA
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number: