Individual
MICHAEL SOUSA-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
502 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5919
(209) 535-5176
Mailing address
214 JUNIPER AVE, ALCOA, TN 37701-2828
(209) 535-5176
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2972
TN
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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