| NPI | 1841995594 |
|---|---|
| Former Name | CHRYSTAL L JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: OH OP.010042-SC) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: OH OP.010042.SC) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-04-03 |