Individual
THEODORE C. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 2ND ST SW, ALBUQUERQUE, NM 87102-3831
(505) 585-3882
(505) 407-8375
Mailing address
8815 TRADEWIND RD NW, ALBUQUERQUE, NM 87121-7021
(505) 585-3882
(505) 407-8375
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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