NPI 1003684317

Joseph a Johnson

Practitioner Prevention Professional Queen Creek, AZ

Practice location

Address: 2791 W Mineral Butte Dr, Queen Creek, AZ 85144-4734
Phone: (623) 703-5765

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 000000 (AZ)

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Registry record

NPI: 1003684317
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Dec 2023
Record last updated: 15 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.