Individual
MR. WILLIAM GORDON JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, LDN
Contact information
Practice address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 475-8100
(337) 475-8416
Mailing address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 475-8100
(337) 475-8416
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2043
LA
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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