Individual
ADAM K JOHNNIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
720 LINDSAY LN, CODY, WY 82414-4103
(307) 578-1970
Mailing address
65 WEIR LN, LOCUST VALLEY, NY 11560-1631
(516) 509-1043
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1445
WY
Other
Enumeration date
09/18/2012
Last updated
09/27/2012
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