Jerelene Elizabeth Johnson

NPI #1275658379 in Big Stone Gap, Virginia

Provider Information

NPI Number: 1275658379
Entity Type: Individual
Name: Jerelene Elizabeth Johnson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Mar 20, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 622 POWELL AVENUE
Address 2: DEVELOPMENTAL SERVICES
City: Big Stone Gap
State: Virginia
ZIP Code: 24219
Phone: (276) 523-0682

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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