Individual
MR. KENDALL DEWAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
744 THE RIALTO, VENICE, FL 34285-3524
(941) 484-5500
Mailing address
3223 BENEVA RD, SARASOTA, FL 34232-4578
(727) 557-9856
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10519
FL
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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