Individual
GREGORY GRIFFIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1310 E BROADWAY ST, CUERO, TX 77954-2133
(361) 275-9133
Mailing address
6043 HWY 72 W, CUERO, TX 77954-6151
(361) 799-9130
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208767
TX
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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