MATTIE RAYDON JOHNSON
Individual Provider (NPI-1)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1003537564- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 625 ALBANY AVE, TORRINGTON, WY, 822401530
- Phone
- (307) 532-2107
Specialties & Taxonomies
Nurse Practitioner, Family
Primary License: WY #44901
All Addresses
MAILING
625 ALBANY AVE
TORRINGTON, WY, 822401530