Individual
KENNETH LARRY JOHNSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 NE 19TH AVE, POMPANO BEACH, FL 33060-6743
(954) 294-5600
Mailing address
216 NE 19TH AVE, POMPANO BEACH, FL 33060-6743
(954) 294-5600
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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