Individual
TAMARA C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MST
Contact information
Practice address
2641 DEVELOPMENT DR, GREEN BAY, WI 54311-4240
(920) 964-3876
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3846-146
WI
Other
Enumeration date
01/03/2020
Last updated
01/15/2020
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