Individual
KELLIE LUCILLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7212 W 135TH ST, OVERLAND PARK, KS 66223-1258
(913) 275-5343
(913) 320-2235
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-06561
KS
225100000X
Physical Therapist
2020027177
MO
Other
Enumeration date
08/19/2020
Last updated
03/01/2021
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