Individual
KIMBERLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16170 KINGSPORT RD, ORLAND PARK, IL 60467-5602
(708) 326-1550
Mailing address
1721 88TH ST, KENOSHA, WI 53143-6482
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009594
IL
225X00000X
Occupational Therapist
5609-26
WI
Other
Enumeration date
05/15/2015
Last updated
05/15/2015
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