Individual
SHANNAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N1737 HOT SPRINGS CT, GREENVILLE, WI 54942-8573
(920) 358-4936
Mailing address
N1737 HOT SPRINGS CT, GREENVILLE, WI 54942-8573
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J5257939396007
WI
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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