Individual
KRISTA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E FERGUSON ST, TYLER, TX 75702-5759
(877) 688-2520
Mailing address
2300 DISCOVERY BLVD APT 3306, ROCKWALL, TX 75032-7065
(330) 719-6374
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2161220
TX
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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