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Individual

MR. BENJAMIN L JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, ATC

Contact information

Practice address
2703 82ND ST, LUBBOCK, TX 79423-1429
(806) 761-0333
(806) 782-0097
Mailing address
5733 107TH ST, LUBBOCK, TX 79424-8247
(806) 792-4329
(806) 795-0986

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
050802360
TX
363A00000X
Physician Assistant
Primary
PA09255
TX

Other

Enumeration date
06/30/2008
Last updated
05/18/2016
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