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Individual

MRS. AMANDA KELLY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T., D.P.T.

Contact information

Practice address
3801 JOHNSON MILL BLVD STE B, FAYETTEVILLE, AR 72704-6364
(479) 295-3320
Mailing address
3785 W SHOAL CREEK LN APT 103, FAYETTEVILLE, AR 72704-6443
(479) 295-3320

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 4169
AR

Other

Enumeration date
09/07/2016
Last updated
09/07/2016
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