Individual
EMILY ROSE ANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4812 E 33RD ST, TULSA, OK 74135-2038
(918) 622-4126
(918) 270-2398
Mailing address
4812 E 33RD ST, TULSA, OK 74135-2038
(918) 622-4126
(918) 270-2398
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3946
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200124060A
—
OK
01
—
9028080
AETNA
OK
Enumeration date
11/02/2006
Last updated
06/20/2012
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