Individual
CLARK JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6055 E WASHINGTON BLVD, SUITE 900, COMMERCE, CA 90040-2449
(323) 346-0960
(323) 346-0966
Mailing address
1826 E 3RD ST, APT. 3, LONG BEACH, CA 90802-3968
(562) 209-6399
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/31/2011
Last updated
03/31/2011
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