Individual
KALISSA J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2121 WILLOW ST, VINCENNES, IN 47591-5355
(812) 882-1141
(812) 255-0045
Mailing address
7300 E INDIANA ST, SUITE 102, EVANSVILLE, IN 47715-2794
(812) 476-0409
(812) 476-1016
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002492A
IN
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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