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Individual

MR. GREG ANTHONY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.O., BOCP

Contact information

Practice address
1027 S MAIN ST STE LL3, JOPLIN, MO 64801-4565
(417) 726-9964
(417) 622-4449
Mailing address
2039 N PENELOPE LN, FAYETTEVILLE, AR 72704-7206
(479) 305-9374

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OP00095
AR
224P00000X
Prosthetist
Primary
OP00095
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C51253
BOARD OF CERTIFICATION
01
CO004206
AMERICAN BOARD OF CERTIFICATION
Enumeration date
10/24/2008
Last updated
10/15/2025
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