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General NPI Number Information
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NPI Number | 1932691490
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Entity Type | Individual
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Provider Name | ADAM JOHNSON AUD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2018
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Last Update Date | 05/31/2018
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Provider Practice Location Address
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Address Line | 140 COLEMANS XING STE 200
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City | MARYSVILLE
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State | OH
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Zip | 43040-7080
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Country | US
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Telephone | 937-565-4174
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Fax |
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Provider Business Mailing Address
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Address Line | 3093 MOUNTVIEW RD
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City | COLUMBUS
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State | OH
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Zip | 43221-2751
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A.02136
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License Number State | OH
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