Individual
COURTNEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
200 MEMORIAL DR, MONDOVI, WI 54755-1325
(715) 926-6123
Mailing address
200 MEMORIAL DR, MONDOVI, WI 54755-1325
(715) 926-4665
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
172819
WI
Other
Enumeration date
07/25/2012
Last updated
01/27/2016
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