Individual
VICKI JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
619 S CLARK AVE, LYONS, KS 67554-3003
(620) 257-5173
(620) 257-3002
Mailing address
1014 S BELL AVE, LYONS, KS 67554-3608
(620) 257-3685
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1701179
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120090
BCBS PROV. NO.
KS
Enumeration date
08/03/2006
Last updated
07/08/2007
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