Individual
KENYADA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 MADISON ST, SYRACUSE, NY 13210-2319
(315) 426-4771
Mailing address
106 ARGONNE DR, SYRACUSE, NY 13207-1151
(315) 426-4771
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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