Individual provider · Type 1 NPI

Corey Dewite Johnson Sr., DIETARY MANAGER

Driver · Kansas City, MO

NPI number 1740029792 Active

Practice location

3442 Wabash Ave
Kansas City, MO 64109-2539

Call (816) 215-0334 Map

Mailing address

7100 E 134th Ter
Grandview, MO 64030-3357

Specialties and licenses

TaxonomyCodeLicense
Driver Primary 172A00000XJ125035005 (MO)

Driver: A person employed to operate a motor vehicle as a carrier of persons or property.

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About NPI 1740029792

Corey Dewite Johnson Sr., DIETARY MANAGER's National Provider Identifier is 1740029792, issued on May 20, 2024. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Kansas City, MO. The record was last updated on May 20, 2024.