Individual
JILLIAN BLAIR JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12020 PACIFIC ST, OMAHA, NE 68154-3507
(800) 259-9897
Mailing address
420 S 4TH ST, EUNICE, LA 70535-5302
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
CP014588A
GA
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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