Individual
ABIGAIL MARTINA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
9622 256TH ST N, PORT BYRON, IL 61275-9054
(309) 523-3184
Mailing address
15368 STACIE CT, DUBUQUE, IA 52002-9424
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IA
Other
Enumeration date
09/06/2019
Last updated
07/15/2020
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