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1477918126
EDGAR JOHNSON HOMER
BROKEN ARROW, OK
NPI
1477918126
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2015-12-23
Last Update Date
2015-12-23
Business Address
EDGAR JOHNSON HOMER MA
8933 S 253RD EAST AVE
BROKEN ARROW, OK 74014-2299
Phone number: 480-529-3630
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Mailing Address
EDGAR JOHNSON HOMER MA
8933 S 253RD EAST AVE
BROKEN ARROW, OK 74014-2299
Phone number: 480-529-3630
Copy
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