Individual
DR. SHANE JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7014 E CAMELBACK RD, SUITE #590, SCOTTSDALE, AZ 85251-1227
(480) 840-0333
Mailing address
11333 N 92ND ST, #1001, SCOTTSDALE, AZ 85260-6106
(623) 688-7310
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2108
AZ
152WS0006X
Sports Vision Optometrist
2108
AZ
Other
Enumeration date
06/17/2016
Last updated
06/20/2016
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