Individual
MR. LYLE FOSTER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTAL
Contact information
Practice address
2657 APD 40, CLEVELAND, TN 37323-0696
(423) 339-1492
(423) 339-1496
Mailing address
2657 APD 40, CLEVELAND, TN 37323-0696
(423) 339-1492
(423) 339-1496
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0000001096
TN
Other
Enumeration date
02/20/2009
Last updated
02/20/2009
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