Individual
EZEKIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
5501 WESTBANK EXPY, MARRERO, LA 70072-2934
(504) 341-6212
Mailing address
520 MYRTLE DR APT 3311, COVINGTON, LA 70433-8274
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
333540
LA
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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