Individual
DANIEL EVAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
515 READ ST, EVANSVILLE, IN 47710-1739
(812) 424-9291
Mailing address
409 E 6TH ST, MOUNT CARMEL, IL 62863-2028
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002728A
IN
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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