Individual provider · NPI-1

Jeffery Kent Johnson, ATC, LAT

Specialist/Technologist, Athletic Trainer · Addison, TX

NPI number1326008376
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1326008376
Entity type
Individual (NPI-1)
Name
Mr. Jeffery Kent Johnson
Credential
ATC, LAT
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 24, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic TrainerAT3431TXYes

Practice location

4141 Spring Valley Rd
Addison, TX 75001-3615

Phone 972-628-5649 · Fax 972-628-5650

Mailing address

4141 Spring Valley Rd
Addison, TX 75001-3615

Phone 972-628-5649 · Fax 972-628-5650

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