Individual
MR. JESSE PAUL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
24 FRANK LLOYD WRIGHT DR, MEDSPORT, ANN ARBOR, MI 48105-9755
(734) 930-7400
Mailing address
6513 MEADOWLARK LN, YPSILANTI, MI 48197-6171
(734) 930-7400
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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