Individual
MARY JOHNSTON
Active
Individual
MARY JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3921
AR
225100000X
Physical Therapist
Primary
4533
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3921
PHYSICAL THERAPY LICENSE
AR
01
—
4533
PHYSICAL THERAPY LICENSE
NM
Enumeration date
09/10/2014
Last updated
09/10/2014
Update your record
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