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WALI RASHAD JOHNSON

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1720472368

Individual Registrant:
 WALI RASHAD JOHNSON 
Gender: M
Sole Proprietor

Location and contact information for practice:
420 WESTBOURNE DR  TYRONE, GA 30290-1657 US
Tel: 770-856-0202  Fax: --

Contact information for business:
420 WESTBOURNE DR  TYRONE, GA 30290-1657 US
Tel: 770-856-0202  Fax: --

Registration Information:
NPI: 1720472368
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y390200000XStudent
Organized Health Care Education/Training Program
GA051737202

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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