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Mr. Jace Jordan Johnson, CPO
Pedorthist in Centerton, Arkansas
NPI 1568131191

Jace Jordan Johnson is a Pedorthist based in Tontitown, AR. Jace Jordan Johnson practices in Centerton, AR and has the professional credentials of CPO. The NPI Number for Jace Jordan Johnson is 1568131191 and holds a License No. OPP00271 (Arkansas).

The current practice location address for Jace Jordan Johnson is 429 W Centerton Blvd, Centerton, AR and can be reached out via phone at 918-843-0713.

Location: 429 W Centerton Blvd, Centerton, AR, 72762-6249
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568131191
Provider Name
Jace Jordan Johnson
Credential
CPO
Provider Entity Type
Individual
Gender
Male
Address
429 W Centerton Blvd, Centerton, AR, 72762-6249
Phone Number
918-843-0713
Fax Number
Provider Enumeration Date
09/08/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
429 W Centerton Blvd
City
Centerton
State
Arkansas
Zip
72719-8701
Phone Number
918-843-0713
Fax Number
person
Provider Business Mailing Address Details
Address
429 W Centerton Blvd
City
Centerton
State
Arkansas
Zip
72719-8701
Phone Number
918-843-0713
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Pedorthist
Speciality
-
Taxonomy
224L00000X
License No.
OPP00271 (Arkansas)
Definition
An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.
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