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Individual

KENNETH JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
6201 SAN AMARO DR, CORAL GABLES, FL 33146-2407
(305) 284-5286
Mailing address
6201 SAN AMARO DR, CORAL GABLES, FL 33146-2407

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 3447
FL

Other

Enumeration date
07/19/2014
Last updated
07/19/2014
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