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1033425145
TIMOTHY W JOHNSON
AVON, IN
NPI
1033425145
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10001198)
Enumeration Date
2010-08-26
Last Update Date
2010-08-26
Business Address
-- TIMOTHY W JOHNSON PA
1111 RONALD REAGAN PKWY
AVON, IN 46123-7085
Phone number: 317-472-7317
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Mailing Address
-- TIMOTHY W JOHNSON PA
5446 RELIABLE PKWY
CHICAGO, IL 60686-0001
Phone number: 317-472-7317
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