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Individual

MR. GARY JOHNSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
800 E 101ST TER STE 350, KANSAS CITY, MO 64131-5310
(816) 721-7938
Mailing address
11904 N WHITE AVE, KANSAS CITY, MO 64156-1098
(816) 721-7938

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Enumeration date
09/22/2025
Last updated
09/22/2025
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