Individual
JONAH MASON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
701 ROBLEY DR STE 135, LAFAYETTE, LA 70503-5223
(337) 991-0102
(337) 991-0032
Mailing address
701 ROBLEY DR STE 135, LAFAYETTE, LA 70503-5223
(337) 991-0102
(337) 991-0032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10214
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10214
PHYSICAL THERAPY LICENSE NUMBER
LA
Enumeration date
02/21/2019
Last updated
02/21/2019
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