Individual
MADISON LYNN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 FOUNDERS DR, CONWAY, SC 29526-8658
(843) 349-2920
Mailing address
3317 AMMONS DR, WILMINGTON, NC 28405-6431
(910) 352-3006
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
NE
Other
Enumeration date
07/30/2018
Last updated
12/06/2019
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