Individual
ANISE M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
77 HAMILTON RD, TEANECK, NJ 07666-6233
(201) 923-7497
Mailing address
77 HAMILTON RD, TEANECK, NJ 07666-6233
(201) 923-7497
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003296-1
NY
2255A2300X
Athletic Trainer
25MT00183200
NJ
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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