Individual
MR. JACE JORDAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
429 W CENTERTON BLVD, CENTERTON, AR 72719-8701
(918) 843-0713
Mailing address
1484 STEELE RD, TONTITOWN, AR 72762-6249
(918) 843-0713
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
OPP00271
AR
Other
Enumeration date
09/08/2021
Last updated
09/11/2025
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