Individual
HENRY JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3942
Mailing address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3942
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10309
LA
Other
Enumeration date
08/19/2006
Last updated
10/15/2021
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