Individual
MR. KENNETH EARL JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
305 N PLAZA DR, APACHE JUNCTION, AZ 85120-5505
(480) 982-7794
Mailing address
305 N PLAZA DR, APACHE JUNCTION, AZ 85120-5505
(480) 982-7794
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10644A
AZ
Other
Enumeration date
02/05/2014
Last updated
02/05/2014
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