Individual
MAKAILA DAWN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3330 E LOUISE DR STE 400, MERIDIAN, ID 83642-5123
(208) 381-2138
Mailing address
3061 N SUNNY SIDE PL, MERIDIAN, ID 83646-2789
(208) 921-0403
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3160
ID
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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