Individual
KENNETH RALPH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
200 MUIR RD, HACIENDA BUILDING, MARTINEZ, CA 94553-4614
(925) 372-3379
Mailing address
2017 ESSEX ST, BERKELEY, CA 94703-2512
(510) 845-7131
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
11618
CA
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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