Individual
THERESA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
2300 SWAN LAKE BLVD, INDEPENDENCE, IA 50644-9707
(319) 334-5155
Mailing address
2300 SWAN LAKE BLVD, INDEPENDENCE, IA 50644-9707
(319) 334-5155
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01608
IA
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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