Individual
SHANNON C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3212 2ND AVE, LAKE CHARLES, LA 70601
(337) 478-8161
Mailing address
217 SAM HOUSTON JONES PKWY, SUITE 103, MOSS BLUFF, LA 70611
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/21/2006
Last updated
06/15/2017
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