Individual
TREGG JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
119 W TUPPER ST, BUFFALO, NY 14201-2142
(716) 853-5010
(716) 853-5020
Mailing address
119 W TUPPER ST, BUFFALO, NY 14201-2142
(716) 853-5010
(716) 853-5020
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000941
VA
224Z00000X
Occupational Therapy Assistant
2624
NM
Other
Enumeration date
10/28/2011
Last updated
10/28/2011
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