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1881019107
NICHOLAS JOHNSON
SAINT LOUIS, MO
NPI
1881019107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: MO 2014003457)
Enumeration Date
2014-02-24
Last Update Date
2021-01-14
Business Address
Mr. NICHOLAS JOHNSON
3015 N BALLAS RD
SAINT LOUIS, MO 63131-2329
Phone number: 314-996-7033
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Mailing Address
Mr. NICHOLAS JOHNSON
3015 N BALLAS RD
SAINT LOUIS, MO 63131-2329
Phone number:
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