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1619971561
GLEN F JOHNSON
FAYETTEVILLE, NC
NPI
1619971561
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 00010366)
Enumeration Date
2005-06-09
Last Update Date
2008-02-13
Business Address
-- GLEN F JOHNSON PA
524 BEAUMONT RD
FAYETTEVILLE, NC 28304-4443
Phone number: 800-476-8646
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Mailing Address
-- GLEN F JOHNSON PA
PO BOX 1070
CHARLOTTE, NC 28201-1070
Phone number: 800-476-8646
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