JACOB DANIEL JOHNSON

TAYLOR, MI
NPI1962760124
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2086S0129X 
(Licence: MI  5101020933)
Additional Taxonomies208600000X Surgery
(Licence: MI  5101020933)
Enumeration Date2012-04-25
Last Update Date2015-11-21
Business Address
Dr. JACOB DANIEL JOHNSON DO
15411 PARK VILLAGE BLVD
TAYLOR, MI 48180-4886
Phone number: 646-714-1984
Mailing Address
Dr. JACOB DANIEL JOHNSON DO
15411 PARK VILLAGE BLVD
TAYLOR, MI 48180-4886
Phone number: