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Individual
MR. JAMES EUGENE JOHNSON
Active
Individual
MR. JAMES EUGENE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.002597
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366007544001
—
IL
05
—
366007544401
—
IL
Enumeration date
09/11/2012
Last updated
09/11/2012
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