Individual
MS. KRISTINE ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4450 CAMP SWIFT RD, FORT DRUM, FORT DRUM, NY 13602
(315) 262-4925
Mailing address
23 CRESCENT ST, CANTON, NY 13617-1105
(315) 262-4925
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001950
NY
2255A2300X
Athletic Trainer
RT004512
PA
Other
Enumeration date
09/20/2009
Last updated
11/07/2025
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