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Individual

ASHLEY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
119 WATSON PLZ, SAINT LOUIS, MO 63126-1962
(314) 961-3787
(314) 961-0974
Mailing address
119 WATSON PLZ, SAINT LOUIS, MO 63126-1962

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2010036459
MO

Other

Enumeration date
07/28/2014
Last updated
07/28/2014
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