Individual
KENNETH ALLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
3345 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-2283
(928) 445-5211
(928) 771-4476
Mailing address
1055 RUTH ST, SUITE 6, PRESCOTT, AZ 86301-1740
(928) 445-5211
(928) 776-8484
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T014750
AZ
Other
Enumeration date
03/06/2008
Last updated
03/06/2008
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