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Individual

BRIAN P JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1151 GAYLORD ST APT 1, DENVER, CO 80206-3074
(352) 514-1611
Mailing address
1151 GAYLORD ST APT 1, DENVER, CO 80206-3074
(352) 514-1611

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
X
X
Enumeration date
05/04/2021
Last updated
05/04/2021
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