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1730403635
JERRY D JOHNSON
MARIPOSA, CA
NPI
1730403635
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-03-22
Last Update Date
2010-03-22
Business Address
-- JERRY D JOHNSON
5037 STROMING RD
MARIPOSA, CA 95338-0099
Phone number: 209-966-2000
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Mailing Address
-- JERRY D JOHNSON
P O BOX 99
MARIPOSA, CA 95338-0099
Phone number: 209-966-2000
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