Individual
MICHELLE M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1 HAWK DR, 103 ELTING GYMNASIUM, NEW PALTZ, NY 12561-2447
(845) 257-3928
Mailing address
24 TURTLE ROCK CT, NEW PALTZ, NY 12561-1127
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001403-1
NY
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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