Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Diane Johnson Tmd Outlet

Organization Orthotic Fitter · NPI 1649389388

Mary Diane Johnson Tmd Outlet is an Orthotic Fitter in Lebanon, Missouri. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

702 S Monroe
Lebanon, MO 65536-3570
Phone: (417) 588-3404
Fax: (417) 588-3404
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthotic Fitter (primary) Taxonomy 225000000X

Record details

NPI number1649389388
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Johnson — Owner/Abc Certified Fitter (Rem0094 · (417) 588-3404
NPI enumeratedAugust 29, 2006
Last updated in NPPESJune 16, 2008
Mailing address702 S Monroe, Lebanon, MO 65536-3570