Individual
MADELINE ELAINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
817 PEAL LN, DANDRIDGE, TN 37725-4707
(865) 705-8190
Mailing address
817 PEAL LN, DANDRIDGE, TN 37725-4707
(865) 705-8190
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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