Provider Demographics
NPI:1730836677
Name:JOHNSON, ANGEL RACHAEL (AHI, CMA, CPT)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:RACHAEL
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AHI, CMA, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 CATHY ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31415-7886
Mailing Address - Country:US
Mailing Address - Phone:912-631-6448
Mailing Address - Fax:
Practice Address - Street 1:1401 CATHY ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31415-7886
Practice Address - Country:US
Practice Address - Phone:912-631-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist