Individual
BRIAN CURTIS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
718 CRATER LAKE AVE, MEDFORD, OR 97504-6525
(541) 601-6541
Mailing address
1084 GLENGROVE AVE, CENTRAL POINT, OR 97502-2794
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16043
OR
Other
Enumeration date
12/03/2010
Last updated
12/03/2010
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