Individual
MR. ELLIS EDWARD JOHNSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
35055 LA HWY 16, STE 1C, DENHAM SPRINGS, LA 70706
(225) 791-7770
(225) 791-7725
Mailing address
PO BOX 392, WATSON, LA 70786
(225) 791-7770
(225) 791-7725
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03226
LA
Other
Enumeration date
08/09/2006
Last updated
01/05/2011
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