Individual
KYLIE MCKENZIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3311
Mailing address
2661 COUNTY ROAD 1400 E, RANTOUL, IL 61866-9722
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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