Individual
BRIAN L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMA
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2709
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2709
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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