Individual
DALE D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
915 HORTON ST, FORT SCOTT, KS 66701-2437
(615) 896-6400
Mailing address
2382 GRAND RD, FORT SCOTT, KS 66701-1888
(615) 896-6400
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1702536
KS
Other
Enumeration date
05/28/2009
Last updated
05/28/2009
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