Individual
MRS. JESSICA D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12492 LAGRANGE ROAD, LOUISVILLE, KY 40245
(502) 813-0706
Mailing address
10118 SUMMIT PARK PL, APT #201, LOUISVILLE, KY 40241
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
264126
KY
Other
Enumeration date
08/20/2020
Last updated
09/21/2022
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