Individual
MR. ANTONIO DEMETRIUS JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.,C.
Contact information
Practice address
48 A ST, NIAGARA FALLS, NY 14303-2009
(716) 990-3308
Mailing address
48 A ST, NIAGARA FALLS, NY 14303-2009
(716) 990-3308
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
083043-1
NY
Other
Enumeration date
11/11/2015
Last updated
11/11/2015
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