Individual
JONI LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2240 E CENTER ST, SUITE D, POCATELLO, ID 83201-2600
(208) 478-1488
(208) 478-1498
Mailing address
2240 E CENTER ST, SUITE D, POCATELLO, ID 83201-2600
(208) 478-1488
(208) 478-1498
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3938
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-3938
LICENSE
ID
Enumeration date
05/29/2015
Last updated
05/29/2015
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