Individual
MRS. KATY SUZANNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3606 MORRIS AVE, SUITE 107, PUEBLO, CO 81008-1369
(719) 225-9908
Mailing address
2114 MOHAWK RD APT B, PUEBLO, CO 81001-1227
(719) 225-9908
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12505
CO
Other
Enumeration date
10/03/2011
Last updated
06/23/2015
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