Individual
MRS. MELISSA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9717 W KUSE RD, FRANKFORT, IL 60423-8003
(708) 268-2877
Mailing address
9717 W KUSE RD, FRANKFORT, IL 60423
(708) 268-2877
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
J52555093663
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
J52555093663
IL
Other
Enumeration date
02/03/2017
Last updated
02/04/2017
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