Individual
PAIGE ELIZABETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 HAWTHORN RD, SALEM, IL 62881-1028
(618) 322-2062
Mailing address
1201 HAWTHORN RD, SALEM, IL 62881-1028
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011107
IL
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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