Individual
MRS. TRACY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2729 S. HWY 65 82, NULL, LAKE VILLAGE, AR 71653
(870) 265-9390
Mailing address
2729 S. HWY 65 82, NULL, LAKE VILLAGE, AR 71653
(870) 265-9390
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2520
AR
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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