Justin William Johnson, O.D. Valid NPI

Individual provider · Optometrist · Rockford, IL

NPI

1518229210

Type

Individual (Type 1)

Primary specialty

Optometrist

Specialty group

Eye and Vision Services Providers

Taxonomy code

152W00000X

License number

046.010546 (IL)

Sex

Male

Sole proprietor

No

Enumerated

2012-06-09

Last updated

2020-01-23