Individual
LAVON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
121 PRESIDENTIAL DR APT B, WILMINGTON, DE 19807-3212
(302) 650-3960
Mailing address
121 PRESIDENTIAL DR APT B, WILMINGTON, DE 19807-3212
(302) 650-3960
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0000856
DE
Other
Enumeration date
02/19/2022
Last updated
02/19/2022
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