Individual
MRS. TIFFANY J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-2600
Mailing address
N3117 SCHMIDT RD, JEFFERSON, WI 53549-9741
(920) 285-4475
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/18/2012
Last updated
09/07/2016
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