Individual
MARY P JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC, ATR
Contact information
Practice address
6785 SW JANET WAY, CORVALLIS, OR 97333-9318
(541) 754-7726
Mailing address
6785 SW JANET WAY, CORVALLIS, OR 97333-9318
(541) 754-7726
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0821645588
OR
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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