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Individual

CARLY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2560 NE HOPKINS CT, PULLMAN, WA 99163-5622
(206) 383-6182
Mailing address
PO BOX 415, PULLMAN, WA 99163-0415
(206) 383-6182

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
60838792
WA

Other

Enumeration date
07/19/2018
Last updated
07/19/2018
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