Individual
LEVI JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
280 1ST ST BLDG 23, HOLLOMAN AFB, NM 88330-8273
(575) 572-3564
Mailing address
224 ESPANA LN, EL PASO, TX 79912-4512
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1301339
TX
225100000X
Physical Therapist
Primary
5867
NM
225100000X
Physical Therapist
CP004023T
OK
Other
Enumeration date
02/05/2018
Last updated
07/28/2022
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