Individual
SIERRA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2036 N WALNUT ST APT 7, BLOOMINGTON, IN 47404-2465
(708) 717-7408
Mailing address
10851 ANTHONY DR, ORLAND PARK, IL 60467-4560
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/27/2019
Last updated
10/27/2019
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