Individual
MR. JAMEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
309 S WASHINGTON ST, DERIDDER, LA 70634-4861
(337) 462-6097
(337) 462-0531
Mailing address
309 S WASHINGTON ST, DERIDDER, LA 70634-4861
(337) 462-6097
(337) 462-0531
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT06472
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT06472
PHYSICAL THERAPIST LIC#
LA
Enumeration date
03/21/2006
Last updated
06/25/2021
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