Individual
DEIRDRE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT LAT ATC
Contact information
Practice address
5500 DIXON DR, RALEIGH, NC 27609-4202
(919) 881-4800
Mailing address
2429 VILLAGE GROVE RD, RALEIGH, NC 27613-3656
(919) 320-8245
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1975
NC
Other
Enumeration date
03/08/2014
Last updated
03/08/2014
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