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Individual

KELLY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSAT, LAT, ATC

Contact information

Practice address
255 THOLE ST, NORFOLK, VA 23505-4199
(757) 423-5770
Mailing address
9553 25TH BAY ST, NORFOLK, VA 23518-1811
(267) 241-7385

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003041
VA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/29/2016
Last updated
10/05/2022
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