Dominic Dwayne Johnson
Dominic Dwayne Johnson is a Community Health Worker in Carbondale, Illinois. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
300 W Oak StCarbondale, IL 62901-1400
Phone: (217) 891-9662
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community Health Worker (primary) | Taxonomy 172V00000X |
|---|
Record details
| NPI number | 1104618529 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | May 21, 2025 |
| Last updated in NPPES | May 21, 2025 |
| Certification date | May 21, 2025 |
| Mailing address | 300 W Oak St, Carbondale, IL 62901-1400 |
Other providers in Carbondale
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Mr. Otis James Duncan, MA
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Deandre Love
300 W Oak St, Carbondale, IL 62901-1400 · (618) 536-6621