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1154752053
ERIC DWAYNE JOHNSON
LAS VEGAS, NV
NPI
1154752053
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2013-12-03
Last Update Date
2013-12-04
Business Address
Mr. ERIC DWAYNE JOHNSON
5615 S PECOS RD
LAS VEGAS, NV 89120-1961
Phone number: 510-294-9760
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Mailing Address
Mr. ERIC DWAYNE JOHNSON
1008 MAPLE PINES AVE
NORTH LAS VEGAS, NV 89081-6801
Phone number: 510-294-9760
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