Individual
MR. ANDREW JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC, LAT
Contact information
Practice address
4575 LAWRENCEVILLE HWY NW, LILBURN, GA 30047-3617
(303) 919-9259
Mailing address
4575 LAWRENCEVILLE HWY NW, LILBURN, GA 30047-3617
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002119
GA
Other
Enumeration date
06/11/2014
Last updated
12/28/2016
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