Individual
MR. GLEN THOMAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
311 W NOTTINGHAM DR, SAN ANTONIO, TX 78209-1887
(210) 824-2314
Mailing address
311 W NOTTINGHAM DR, SAN ANTONIO, TX 78209-1887
(210) 824-2314
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2118597
TX
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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