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1811713043
J MICHAEL JOHNSON
BROKEN ARROW, OK
NPI
1811713043
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date
2024-12-03
Last Update Date
2024-12-03
Business Address
J MICHAEL JOHNSON
2548 E KENOSHA ST
BROKEN ARROW, OK 74014-6712
Phone number: 918-355-0993
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Mailing Address
J MICHAEL JOHNSON
2548 E KENOSHA ST
BROKEN ARROW, OK 74014-6712
Phone number: 918-355-0993
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