Individual
KIMBERLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-4116
Mailing address
3916 LAKE VALLEY CT, KINGSPORT, TN 37664-5197
(423) 288-9161
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1484
TN
225XH1200X
Hand Occupational Therapist
1484
TN
225XR0403X
Driving and Community Mobility Occupational Therapist
Primary
1484
TN
Other
Enumeration date
04/04/2007
Last updated
09/11/2025
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