Individual
KRISTINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1250 SISKIYOU BLVD, ASHLAND, OR 97520-5010
(541) 552-6827
Mailing address
2528 SISKIYOU BLVD, ASHLAND, OR 97520-9513
(541) 282-4928
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-1007301
OR
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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