National Provider Identifier
Antonio Demetrius Johnson Jr., A.T., C.
Antonio Demetrius Johnson Jr., A.T., C. is listed in the NPPES registry with a primary specialty of Athletic Trainer in Niagara Falls, NY and a listed phone number of (716) 990-3308.
Profile Overview
- NPI
- 1578936647
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- November 11, 2015
- Last Updated
- November 11, 2015
Practice Location
- 48 A St
- Niagara Falls, NY 14303-2009
Phone: (716) 990-3308
Specialties
- Athletic Trainer (2255A2300X)
Full Record
- NPI
- 1578936647
- Entity Type
- Individual
- Last Name
- Johnson
- First Name
- Antonio
- Middle Name
- Demetrius
- Name Prefix
- Mr.
- Name Suffix
- Jr.
- Credential
- A.T., C.
- Mailing Street Address
- 48 A St
- Mailing City
- Niagara Falls
- Mailing State
- NY
- Mailing ZIP Code
- 14303-2009
- Mailing Country
- US
- Mailing Phone
- (716) 990-3308
- Practice Street Address
- 48 A St
- Practice City
- Niagara Falls
- Practice State
- NY
- Practice ZIP Code
- 14303-2009
- Practice Country
- US
- Practice Phone
- (716) 990-3308
- Enumeration Date
- November 11, 2015
- Last Updated
- November 11, 2015
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X)