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Mr. Dermaine Antwan Johnson, CERTIFIEDHAIRLOSS
Prosthetics Case Management in Meridian, Mississippi
NPI 1073975066

Dermaine Antwan Johnson is a Prosthetics Case Management based in Meridian, MS and is specialized in Prosthetics Case Management. Dermaine Antwan Johnson practices in Meridian, MS and has the professional credentials of CERTIFIEDHAIRLOSS. The NPI Number for Dermaine Antwan Johnson is 1073975066 and holds a License No. 5055 (Mississippi).

The current practice location address for Dermaine Antwan Johnson is 3500 Highway 39 N Apt 77, Meridian, MS and can be reached out via phone at 334-505-7628.

Location: 3500 Highway 39 N Apt 77, Meridian, MS, 39301-1339
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073975066
Provider Name
Dermaine Antwan Johnson
Credential
CERTIFIEDHAIRLOSS
Provider Entity Type
Individual
Gender
Male
Address
3500 Highway 39 N Apt 77, Meridian, MS, 39301-1339
Phone Number
334-505-7628
Fax Number
Provider Enumeration Date
03/28/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3500 Highway 39 N Apt 77
City
Meridian
State
Mississippi
Zip
39301-1339
Phone Number
334-505-7628
Fax Number
person
Provider Business Mailing Address Details
Address
3500 Highway 39 N Apt 77
City
Meridian
State
Mississippi
Zip
39301-1339
Phone Number
334-505-7628
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
Prosthetics Case Management
Taxonomy
1744P3200X
License No.
5055 (Mississippi)
Definition
Definition to come...
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