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Individual

ERIN KAITLYN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, PTA

Contact information

Practice address
112 2ND ST NW, WAVERLY, IA 50677-2619
(319) 352-1012
Mailing address
1731 10TH AVE SW APT 2, WAVERLY, IA 50677-3775
(515) 227-2597

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
084252
IA
2255A2300X
Athletic Trainer
Primary
2000020757
IA

Other

Enumeration date
08/28/2017
Last updated
08/28/2017
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