Individual
MR. GUS JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 OUIDA DR, NATCHITOCHES, LA 71457-5446
(318) 352-5961
(318) 352-5965
Mailing address
750 OUIDA DR, NATCHITOCHES, LA 71457-5446
(318) 352-5961
(318) 352-5965
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
10952
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008869
—
LA
Enumeration date
08/16/2007
Last updated
08/16/2007
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