Individual
MS. PHYLLIS S. JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5495 ESCALADE DR, MOUNT JULIET, TN 37122-8446
(615) 479-9506
(615) 773-8929
Mailing address
5495 ESCALADE DR, MOUNT JULIET, TN 37122-8446
(615) 479-9506
(615) 773-8929
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
KY-A3861
KY
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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