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Individual

ALAN D JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
172 HILLCREST DR, FORT COLLINS, CO 80521-5111
(970) 792-7850
Mailing address
172 HILLCREST DR, FORT COLLINS, CO 80521-5111
(970) 792-7850

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
172V00000X
Community Health Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106402907
WY
05
106402908
WY
Enumeration date
05/11/2017
Last updated
10/23/2024
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