MR. Russell Johnson
NPI #1447205554 in Petersburg, Virginia
Provider Information
- NPI Number
- 1447205554
- Entity Type
- Individual
- Name
- MR. Russell Johnson
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Enumeration Date
- May 24, 2006
- Last Updated
- Jul 7, 2016
Practice Location
- Address
- 601 OLD WAGNER RD
- Address 2
- SUITE 101
- City
- Petersburg
- State
- Virginia
- ZIP Code
- 23805-9313
- Phone
- (804) 524-2260
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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