NPI 1134732290
Ida Johnican
Practice location
- Address
- 491 S Sanga Rd, Cordova, TN 38018-7686
- Phone
- (901) 230-4309
Registered specialties
Driver
Primary
Registry record
- NPI
- 1134732290
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 28 Aug 2020
- Record last updated
- 28 Aug 2020
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.