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Individual
MRS. JENNIFER JEAN JOHNSON
Active
Individual
MRS. JENNIFER JEAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T., M.A.
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
PT020901
PA
207PS0010X
Sports Medicine (Emergency Medicine) Physician
PT020901
PA
225100000X
Physical Therapist
Primary
PT020901
PA
Other
Enumeration date
10/20/2010
Last updated
10/28/2010
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