Larry Johnson SR.

NPI #1093103491 in Waco, Texas

Provider Information

NPI Number: 1093103491
Entity Type: Individual
Name: Larry Johnson SR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Private Vehicle
Enumeration Date: Jan 7, 2015
Last Updated: Jan 7, 2015

Practice Location

Address: 600 LAKE AIR DR
Address 2: SUITE 3A
City: Waco
State: Texas
ZIP Code: 76710-5887
Phone: (254) 224-6208

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Private Vehicle	347C00000X	Primary

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