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Individual

CONSTANCE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
2222 E HIGHLAND AVE, SUITE 300, PHOENIX, AZ 85016-4872
(602) 277-6211
(866) 242-5309
Mailing address
2222 E HIGHLAND AVE, STE 300, PHOENIX, AZ 85016-4872
(602) 277-6211
(866) 242-5309

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0193
AZ
225XH1200X
Hand Occupational Therapist
Primary
0193
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0193
LICENSE #
AZ
05
095978
AZ
Enumeration date
06/01/2007
Last updated
03/26/2013
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