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Individual

JOSHUA R JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
400 S. KENNEDY, BRADLEY, IL 60915
(815) 928-8050
(800) 505-2218
Mailing address
400 S KENNEDY DR, BRADLEY, IL 60915-2682
(815) 928-8050
(800) 505-2218

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085003901
IL

Other

Enumeration date
02/24/2011
Last updated
02/24/2011
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