Individual
MR. ROGER DALE JOHNSTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
160 KEONEKAI RD APT 27-206, KIHEI, HI 96753-7145
(801) 592-6432
Mailing address
160 KEONEKAI RD APT 27-206, KIHEI, HI 96753-7145
(801) 592-6432
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/02/2013
Last updated
11/02/2023
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