Individual
DR. KATIE LEA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
424 N UNIVERSITY AVE STE 5AND6, LITTLE ROCK, AR 72205-3109
(501) 663-1131
Mailing address
9401 JOHNSON RD, MABELVALE, AR 72103-2951
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2651
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184071722
—
AR
Enumeration date
07/25/2010
Last updated
03/09/2011
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