Individual
MR. ELI B. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
2025 E AZTEC AVE, GALLUP, NM 87301-4803
(505) 863-3828
(505) 863-6612
Mailing address
2025 E AZTEC AVE, GALLUP, NM 87301-4803
(505) 863-3828
(505) 863-6612
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/10/2021
Last updated
08/12/2021
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