SHANE JOHNSON

SURPRISE, AZ
NPI1548610041
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: AZ  2743)
Enumeration Date2016-06-15
Last Update Date2016-06-15
Business Address
-- SHANE JOHNSON OTR/L
18480 W PORT ROYALE LN
SURPRISE, AZ 85388-7678
Phone number: 623-776-5626
Mailing Address
-- SHANE JOHNSON OTR/L
18480 W PORT ROYALE LN
SURPRISE, AZ 85388-7678
Phone number: 623-776-5626
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