Individual
MRS. NICOLE LEANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2102 ODELL LN, ALMA, AR 72921-7802
(479) 462-5915
(479) 430-7458
Mailing address
2102 ODELL LN, ALMA, AR 72921-7802
(479) 462-5915
(479) 430-7458
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7036
AR
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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