Individual
HERBERT ELTON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5881 W 16TH ST, SUITE D, GREELEY, CO 80634-2910
(970) 353-1551
(970) 350-2478
Mailing address
5881 W 16TH ST, SUITE D, GREELEY, CO 80634-2910
(970) 353-1551
(970) 350-2478
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
374
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02706229
—
CO
Enumeration date
07/08/2005
Last updated
07/11/2016
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