NPI 1023755048

Botlhale Dorica Johnson

Practitioner Driver Summerville, SC

Practice location

Address: 1009 Whitlow Blvd, Summerville, SC 29483-5344
Phone: (843) 822-3605

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1023755048
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 May 2022
Record last updated: 20 May 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.