Individual
REBECCA LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
802 N RIVERSIDE RD, SUITE 250, SAINT JOSEPH, MO 64507-9794
(816) 271-7676
Mailing address
1705 4TH AVE, SAINT JOSEPH, MO 64505-2108
(816) 383-3979
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2004035417
MO
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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