Individual
KATHLEEN VANCE JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1318 MEMORIAL DR, BRYAN, TX 77802-5215
(979) 776-2872
(979) 776-1456
Mailing address
1318 MEMORIAL DR, BRYAN, TX 77802-5215
(979) 776-2872
(979) 776-1456
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4043060
TX
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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