Individual
MR. SCOTT PATRICK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.,C
Contact information
Practice address
1611 SCENIC DR, MODESTO, CA 95355-4907
(209) 576-1805
Mailing address
901 EDISON AVE, MODESTO, CA 95350-5548
(209) 544-0984
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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