Individual
KALLI ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2515 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-5155
(507) 261-1716
Mailing address
11154 DRAKE ST NW, COON RAPIDS, MN 55433-7434
(507) 261-1716
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2525
MN
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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