Individual
JON ROBERT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO, LPO
Contact information
Practice address
1101 W VICKERY BLVD, FORT WORTH, TX 76104-1025
(682) 303-3116
(682) 885-5606
Mailing address
PO BOX 99283, FORT WORTH, TX 76199-1383
(682) 885-6294
(682) 885-5606
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
1273
TX
224P00000X
Prosthetist
Primary
1273
TX
247200000X
Other Technician
ATP94445
TX
Other
Enumeration date
08/06/2009
Last updated
09/08/2022
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