Individual
MICHAEL SCOT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1210 A ST, ANTIOCH, CA 94509-2327
(920) 740-7920
Mailing address
7200 JACINTO AVE, UNIT 15202, SACRAMENTO, CA 95823-7555
(920) 740-7920
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5089-27
WI
Other
Enumeration date
11/28/2014
Last updated
11/28/2014
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