Individual
BENJAMIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
(916) 612-6952
Mailing address
5757 VICTORIA AVE, RIVERSIDE, CA 92506-3368
(916) 612-6952
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
297043
CA
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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