Individual
ABIGAIL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2305 SAN LUIS PL, GREEN BAY, WI 54304-5211
(920) 494-5231
Mailing address
3235 W POINT RD, GREEN BAY, WI 54313-5219
(920) 471-8042
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1802-019
WI
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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