Individual
JACINDA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
327 E CARDINAL GLEN DR, BLOOMINGTON, IN 47401-9239
(812) 545-6190
Mailing address
327 E CARDINAL GLEN DR, BLOOMINGTON, IN 47401-9239
(812) 545-6190
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21104128
IN
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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