Individual
KIMBERLY LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
119 TRUXTON AVE, FT WALTON BCH, FL 32547-2460
(850) 974-6518
(850) 863-1765
Mailing address
119 TRUXTON AVE, FT WALTON BCH, FL 32547-2460
(850) 974-6518
(850) 863-1765
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA31011
FL
Other
Enumeration date
06/20/2007
Last updated
07/08/2007
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