Mrs. DESERAE LEI JOHNSON -- LMT
Individual Provider (NPI-1)
Active
Specialist
Provider Information
- NPI Number
1033537170- Provider Type
- Individual Provider (NPI-1)
- Credentials
- LMT
- Status
- Active
Contact & Location
- Address
- 1654 W BOISE ST, KUNA, ID, 836343137
- Phone
- (208) 409-0422
Specialties & Taxonomies
Specialist
Primary License: ID #MAS-1035