Individual
KENDRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
39542 GOLDEN LAKE PARK RD, OCONOMOWOC, WI 53066-9405
(262) 719-9072
Mailing address
39542 GOLDEN LAKE PARK RD, OCONOMOWOC, WI 53066-9405
(262) 719-9072
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
WI
Other
Enumeration date
05/01/2019
Last updated
11/27/2023
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