Individual
MRS. EMILY MARGARET JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
716 PILGRIM WAY, GREEN BAY, WI 54307-9070
(920) 465-5171
Mailing address
4464 BEECHNUT CIR, NEW FRANKEN, WI 54229-9637
(920) 465-5171
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
487-039
WI
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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