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Amelia M Johnson, DPO
Optician in Sparta, Tennessee
NPI 1023099512

Amelia M Johnson is a Optician based in Sparta, TN and is specialized in Optician. Amelia M Johnson practices in Sparta, TN and has the professional credentials of DPO. The NPI Number for Amelia M Johnson is 1023099512 and holds a License No. DPO1192 (Tennessee).

The current practice location address for Amelia M Johnson is 25 N Main St, Sparta, TN and can be reached out via phone at 931-836-2235 and via fax at 931-836-3036.

Location: 25 N Main St, Sparta, TN, 38583-2055
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023099512
Provider Name
Amelia M Johnson
Credential
DPO
Provider Entity Type
Individual
Gender
Female
Address
25 N Main St, Sparta, TN, 38583-2055
Phone Number
931-836-2235
Fax Number
931-836-3036
Provider Enumeration Date
11/10/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4073352 01 TN BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
25 N Main St
City
Sparta
State
Tennessee
Zip
38583-2055
Phone Number
931-836-2235
Fax Number
931-836-3036
person
Provider Business Mailing Address Details
Address
25 N Main St
City
Sparta
State
Tennessee
Zip
38583-2055
Phone Number
931-836-2235
Fax Number
931-836-3036
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
DPO1192 (Tennessee)
Definition
Definition to come...
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