Individual
OWEN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT, LAT, ATC
Contact information
Practice address
1500 E MICHIGAN ST, INDIANAPOLIS, IN 46201-3079
(920) 257-8569
Mailing address
6651 BUCKHORN DR APT 611, INDIANAPOLIS, IN 46254-6214
(920) 257-8569
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36004022A
IN
Other
Enumeration date
04/07/2026
Last updated
04/07/2026
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