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Individual

GLENN A JOHNSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2565 CEANOTHUS AVE, STE 155, CHICO, CA 95973-7615
(530) 899-3939
Mailing address
2565 CEANOTHUS AVE, STE 155, CHICO, CA 95973-7615
(530) 899-3939

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6257 TPL
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SD0062570
CA
Enumeration date
08/08/2006
Last updated
06/10/2008
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