Individual
LEONDRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 S CHESTNUT ST STE 107, LUFKIN, TX 75901-0830
(936) 219-8699
Mailing address
417 S CHESTNUT ST STE 107, LUFKIN, TX 75901-0830
(936) 219-8699
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
335E00000X
PROSTHETIC/ORTHOTIC SUPPLIER
TX
Enumeration date
12/15/2022
Last updated
12/20/2022
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