IKE JOHNSON

GRANTS PASS, OR
NPI1679217905
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2022-04-22
Last Update Date2022-04-22
Business Address
IKE JOHNSON
109 NE MANZANITA AVE
GRANTS PASS, OR 97526-1400
Phone number: 541-476-2373
Mailing Address
IKE JOHNSON
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
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