Individual
TANYA D. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
704 W GROVE ST, SUITE 5, EL DORADO, AR 71730-4416
(870) 862-1144
(870) 864-0782
Mailing address
1945 SCOTTSVILLE RD, B2, PMB 356, BOWLING GREEN, KY 42104-3376
(270) 842-8824
(270) 842-7917
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1480
AR
Other
Enumeration date
09/14/2007
Last updated
09/14/2007
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