MR. Russell Laroy Johnson

NPI #1659782787 in Fontana, California

Provider Information

NPI Number: 1659782787
Entity Type: Individual
Name: MR. Russell Laroy Johnson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Enumeration Date: May 12, 2014
Last Updated: May 12, 2014

Practice Location

Address: 11629 SUENO CT.
City: Fontana
State: California
ZIP Code: 92337
Phone: (323) 801-9208

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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