Individual
IAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7723 JASPER AVE, JACKSONVILLE, FL 32211-7719
(904) 725-8044
Mailing address
18 FISHERMANS CIR APT 8, ORMOND BEACH, FL 32174-9140
(386) 451-9903
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
16615
FL
Other
Enumeration date
04/23/2022
Last updated
04/23/2022
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