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MICAH JOHNSON

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1942690219

Individual Registrant:
 MICAH  JOHNSON 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
INDIAN ROUTE 19 MILE POST 19.5 TOPAWA, AZ 85639 US
Tel: 520-383-6800  Fax: --

Contact information for business:
PO BOX 2332  SELLS, AZ 85634-2332 US
Tel: 520-383-6800  Fax: --

Registration Information:
NPI: 1942690219
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
AZ1230

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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