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Individual

BAYLEE RHAE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8109 LUKE CT, SPEARFISH, SD 57783-6344
(760) 885-5952
Mailing address
2132 MONUMENT DR, VIRGINIA BEACH, VA 23464-9014
(760) 885-5952

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HID174M53590
ATHLETIC TRAINER
VA
Enumeration date
02/15/2023
Last updated
02/15/2023
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