Individual
ALICIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
331 S WATER ST, SPARTA, WI 54656-1726
(608) 269-3168
Mailing address
331 S WATER ST, SPARTA, WI 54656-1726
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5283-27
WI
Other
Enumeration date
10/22/2016
Last updated
10/22/2016
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