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Individual

DANIEL R JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RDN, LDN, CEP

Contact information

Practice address
IHS PINON HEALTH CENTER NAVAJO RT 4, PINON, AZ 86510
(928) 674-7166
(928) 674-7705
Mailing address
P.O. DRAWER PH, CHINLE, AZ 86503
(928) 674-7166
(928) 674-7705

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
1053031
CA
133N00000X
Nutritionist
DX3643
MD
133V00000X
Registered Dietitian
Primary
1053031
CA
133V00000X
Registered Dietitian
DX3643
MD

Other

Enumeration date
07/10/2014
Last updated
08/25/2015
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