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Individual

JAMES CLIFFORD JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTA

Contact information

Practice address
31 VAIL RD, LAKE HIAWATHA, NJ 07034-3119
(917) 913-9853
Mailing address
31 VAIL RD, LAKE HIAWATHA, NJ 07034-3119
(917) 913-9853

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09110200
NJ

Other

Enumeration date
03/03/2022
Last updated
03/03/2022
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