Individual
JERRY ROY JOHNSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
1641 E OSBORN RD, SUITE 6, PHOENIX, AZ 85016-7146
(602) 265-1774
(602) 265-1738
Mailing address
1641 E OSBORN RD, SUITE 6, PHOENIX, AZ 85016-7146
(602) 265-1774
(602) 265-1738
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-14033
AZ
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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