Healthcare Provider Details

I. General information

NPI: 1871160184
Provider Name (Legal Business Name): ERIKA JANICE JOHLER RDCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2021
Last Update Date: 06/06/2021
Certification Date: 06/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 COLORADO BLVD STE 102
DENTON TX
76210-6889
US

IV. Provider business mailing address

PO BOX 111307
CARROLLTON TX
75011-1307
US

V. Phone/Fax

Practice location:
  • Phone: 207-768-1479
  • Fax:
Mailing address:
  • Phone: 207-768-1479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number106284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: