Individual
MR. GREGG JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 W MAIN ST, PURCELL, OK 73080-4220
(405) 527-1785
(405) 527-1084
Mailing address
PO BOX 662, PURCELL, OK 73080-0662
(405) 527-1785
(405) 527-1084
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/25/2010
Last updated
04/29/2024
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