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MR. JACOB DARRELL JOHNSON DPT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1174873723

Individual Registrant:
MR. JACOB DARRELL JOHNSON DPT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1515 NORTH CENTER STREET SUITE 5 LONOKE, AR 72086 US
Tel: 501-676-5540  Fax: 501-676-6499

Contact information for business:
1515 NORTH CENTER STREET SUITE 5 LONOKE, AR 72086 US
Tel: 501-676-5540  Fax: 501-676-6499

Registration Information:
NPI: 1174873723
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
ARPT 3506

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
127083742AR05




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