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Individual
LARCELL THOMAS JOHNSON
Active
Individual
LARCELL THOMAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
51625
CA
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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