Individual
PARKER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4141 POLE LINE ROAD, STE A, POCATELLO, ID 83202-4904
(208) 242-8617
(833) 608-2470
Mailing address
4141 POLE LINE ROAD, STE A, POCATELLO, ID 83202-4904
(208) 242-8617
(833) 608-2470
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
ID
Other
Enumeration date
08/28/2023
Last updated
08/09/2024
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