Individual
JAYME RENEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
145 S CHAMBERLAIN ST, ROSEVILLE, IL 61473-9581
(309) 426-2134
Mailing address
225 N UNION ST, GOOD HOPE, IL 61438-9172
(309) 337-4231
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008612
IL
Other
Enumeration date
09/16/2021
Last updated
09/20/2021
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