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MR. ROBERT LEROY JOHNSON
Attendant Care Provider >> Technician >> Nursing Service Related ProvidersRegistrant NPI Number: 1053945352
Individual Registrant:MR. ROBERT LEROY JOHNSON
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
29 TUCKER RD HARDY, AR 72542-9115 US
Tel: 870-955-0972 Fax: --
Tel: 870-955-0972 Fax: --
Contact information for business:
29 TUCKER RD. HARDY, AR 72542 US
Tel: 870-955-0972 Fax: --
Tel: 870-955-0972 Fax: --
Registration Information:
NPI: 1053945352
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 3747A0650X | Nursing Service Related Providers Technician Attendant Care Provider |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
