Individual
MR. GLEN ERIC JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3280 FISSELS CHURCH RD, GLEN ROCK, PA 17327-8774
(717) 235-4811
Mailing address
736 CAPRI CIR, LEWISBERRY, PA 17339-9584
(717) 932-4269
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT001236A
PA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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