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1720346943
ANTQUALENE LAVETTE JOHNSON
FORT POLK, LA
NPI
1720346943
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: 1103343)
Enumeration Date
2012-04-25
Last Update Date
2012-04-25
Business Address
Mrs. ANTQUALENE LAVETTE JOHNSON PA-C
2260 GLORY LOOP BLDG 1260
FORT POLK, LA 71446
Phone number: 337-531-4127
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Mailing Address
Mrs. ANTQUALENE LAVETTE JOHNSON PA-C
2260 GLORY LOOP BLDG 1260
FORT POLK, LA 71446
Phone number: 337-531-4127
Copy
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