Individual
LORA BROOKE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, CLT, MS
Contact information
Practice address
27 GREEN MOUNTAIN DR UNIT 306, SOUTH BURLINGTON, VT 05403-7965
(802) 249-2909
Mailing address
27 GREEN MOUNTAIN DR UNIT 306, SOUTH BURLINGTON, VT 05403-7965
(802) 249-2909
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
2255A2300X
Athletic Trainer
Primary
080302236
VT
Other
Enumeration date
10/15/2013
Last updated
11/02/2020
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