Individual
BAILEY MACKENZIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3109 FURNEAUX LN, CARROLLTON, TX 75007-3514
(214) 803-8857
Mailing address
3109 FURNEAUX LN, CARROLLTON, TX 75007-3514
(214) 803-8857
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000038618
TX
Other
Enumeration date
09/04/2018
Last updated
07/02/2020
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