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General NPI Number Information
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NPI Number | 1508686106
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Entity Type | Organization
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Legal Business Name | JOHNSON PROSTHETICS & ORTHOTICS LLC
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1027 S MAIN ST STE LL3
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City | JOPLIN
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State | MO
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Zip | 64801-4565
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Country | US
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Telephone | 417-726-9964
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Fax | 417-622-4449
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Provider Business Mailing Address
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Address Line | 1027 S MAIN ST STE LL3
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City | JOPLIN
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State | MO
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Zip | 64801-4565
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Country | US
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Telephone | 417-726-9964
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Fax | 417-622-4449
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | GREG JOHNSON
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Credential | CO, BOCP
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Telephone | 479-305-9374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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