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General NPI Number Information
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NPI Number | 1942452867
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Entity Type | Organization
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Legal Business Name | JOHNSON ASSOCIATES SYSTEMS INC.
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 1011 HONOR HEIGHTS DR
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City | MUSKOGEE
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State | OK
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Zip | 74401-1318
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Country | US
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Telephone | 918-577-3542
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Fax | 918-577-3623
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Provider Business Mailing Address
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Address Line | 1011 HONOR HEIGHTS DR
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City | MUSKOGEE
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State | OK
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Zip | 74401-1318
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Country | US
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Telephone | 918-577-3542
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Fax | 918-577-3623
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Authorized Official
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Title or Position | ABC CERTIFIED ORTHOTIST
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Name | MR. KERRY DORIN SCHULTZ
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Credential | CERTIFIED ORTHOTIST
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Telephone | 918-577-3542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number | CERT. # CO004446
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License Number State | DE
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