Individual
JESSICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12468 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2506
(314) 739-1123
(314) 739-1173
Mailing address
600 OAKMONT LN, STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
(630) 928-5080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2016026835
MO
Other
Enumeration date
08/12/2016
Last updated
01/02/2025
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