Individual
MS. TRACI JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
4650 W. SWEETWATER AVE., GLENDALE, AZ 85304-1505
(602) 347-2600
Mailing address
4650 W. SWEETWATER AVE., GLENDALE, AZ 85304-1505
(602) 347-2600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2581
AZ
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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