Individual
ANGELA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
103 E NURSERY ST, BUTLER, MO 64730-2331
(615) 896-6400
Mailing address
6620 NW 1000 RD, APPLETON CITY, MO 64724-3134
(615) 896-6400
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2007018391
MO
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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