Provider Demographics
NPI:1548560170
Name:JOHNS, ROBERT A (LCPED)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:JOHNS
Suffix:
Gender:M
Credentials:LCPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 SPENCERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3442
Mailing Address - Country:US
Mailing Address - Phone:419-227-2829
Mailing Address - Fax:419-227-7699
Practice Address - Street 1:2110 SPENCERVILLE RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-3442
Practice Address - Country:US
Practice Address - Phone:419-227-2829
Practice Address - Fax:419-227-7699
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPED.20224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist