Micah Johnson

NPI #1326469248 in Pueblo, Colorado

Provider Information

NPI Number
1326469248
Entity Type
Individual
Name
Micah Johnson
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Enumeration Date
Dec 19, 2013
Last Updated
Dec 19, 2013

Practice Location

Address
1600 N GRAND AVE
Address 2
SUITE 508
City
Pueblo
ZIP Code
81003-2700
Phone
(719) 595-7040

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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