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Individual

MACKENZIE DENISE JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6251 OVERTON RIDGE BLVD, FORT WORTH, TX 76132-3755
(866) 891-1294
Mailing address
2220 BIRD ST APT 1231, FORT WORTH, TX 76111-1394
(806) 290-3940

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2149211
TX

Other

Enumeration date
09/18/2019
Last updated
09/18/2019
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