Individual
MR. GRANT EDWARD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1221 HILLTOP ST, GIBSLAND, LA 71028
(318) 843-6090
(318) 843-6090
Mailing address
P O BOX 423, 1221 HILLTOP ST, GIBSLAND, LA 71028
(318) 843-6090
(318) 843-6090
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
008591754
LA
343900000X
Non-emergency Medical Transport (VAN)
Primary
41235361K
LA
Other
Enumeration date
01/27/2014
Last updated
01/27/2014
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