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Individual

WOODY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
521 GASLIGHT BLVD, LUFKIN, TX 75904-3127
(936) 634-3298
Mailing address
521 GASLIGHT BLVD, LUFKIN, TX 75904-3127

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
1378
TX
224P00000X
Prosthetist
Primary
1378
TX

Other

Enumeration date
11/24/2014
Last updated
11/24/2014
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