Individual
BONNIE LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7235 W APPLETON AVE, MILWAUKEE, WI 53216-1932
(414) 815-6700
(414) 755-1434
Mailing address
PO BOX 639, THIENSVILLE, WI 53092-0639
(414) 247-9005
(414) 247-9004
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001091
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669788097
—
WI
Enumeration date
08/23/2010
Last updated
08/14/2014
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