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Individual

PATRICIA ANN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMT

Contact information

Practice address
2131 JERRY MURPHY RD, PUEBLO, CO 81001-1262
(719) 546-0037
Mailing address
417 W VENTURI DR, PUEBLO WEST, CO 81007-6008
(719) 547-8482
(719) 647-0398

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
9529
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
793912
ASSOCIATED MASSAGE AND BODYWORK PROFESSIONALS
CO
01
9529
STATE OF CO, DIVISION OF REGISTRATIONS
CO
Enumeration date
07/12/2010
Last updated
07/12/2010
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