Individual
MRS. SUELLEN CAROLINE CRUZ JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2020014754
MO
Other
Enumeration date
06/16/2020
Last updated
06/16/2020
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