MARSHALL WALLACE JOHNSON

KLAMATH FALLS, OR
NPI1982259669
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2019-08-08
Last Update Date2020-08-11
Business Address
MARSHALL WALLACE JOHNSON
2210 N ELDORADO AVE
KLAMATH FALLS, OR 97601-6418
Phone number: 541-883-1030
Mailing Address
MARSHALL WALLACE JOHNSON
2210 N ELDORADO AVE
KLAMATH FALLS, OR 97601-6418
Phone number: 541-883-1030
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