Individual
KEVIN ROBERT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT, OTR/L
Contact information
Practice address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
(405) 440-6711
Mailing address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
(405) 440-6711
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2150
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200729120A
—
OK
Enumeration date
09/06/2017
Last updated
07/21/2022
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