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1598421000
OCTAVIA T JOHNSON
VALDOSTA, GA
NPI
1598421000
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
Enumeration Date
2021-11-10
Last Update Date
2021-11-10
Business Address
OCTAVIA T JOHNSON
1341 W HILL AVE
VALDOSTA, GA 31601-5235
Phone number: 229-249-7730
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Mailing Address
OCTAVIA T JOHNSON
1341 W HILL AVE
VALDOSTA, GA 31601-5235
Phone number: 229-249-7730
Copy
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