Individual
TRISTA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2361 LAKEWOOD AVE, LIMA, OH 45805-3175
(419) 604-9143
Mailing address
2361 LAKEWOOD AVE, LIMA, OH 45805-3175
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR 009442
OH
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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