Individual
MIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17880 W SCHULTE RD, TRACY, CA 95377-8909
(209) 221-6200
Mailing address
3811 LANYARD DR, STOCKTON, CA 95206-4958
(209) 594-9977
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
—
—
Other
Enumeration date
01/11/2020
Last updated
01/11/2020
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