Individual
JENIFER RENE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 17TH AVE, VERO BEACH, FL 32960-3641
(772) 562-6877
Mailing address
1524 PAR CT, VERO BEACH, FL 32966-2505
(772) 486-1299
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA23396
FL
Other
Enumeration date
12/04/2012
Last updated
02/22/2017
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