Individual
MISS KIERSTON ALEXIS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
1875 MALAGA RD, MAYS LANDING, NJ 08330-4114
(609) 892-6615
Mailing address
1875 MALAGA RD, MAYS LANDING, NJ 08330-4114
(609) 892-6615
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00331800
NJ
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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