Individual
AUTUMN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1547 BYPASS RD, WINCHESTER, KY 40391-2714
(185) 974-4441
Mailing address
111 HAVERFORD PATH APT 4, GEORGETOWN, KY 40324-2662
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005715
KY
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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