Individual
AMANDA KAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
8751 W CHARLESTON BLVD, #270, LAS VEGAS, NV 89117-5480
(702) 982-2232
(702) 982-2237
Mailing address
8751 W CHARLESTON BLVD, #270, LAS VEGAS, NV 89117-5480
(702) 982-2232
(702) 982-2237
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
T-03590
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-03590
KANSAS LICENSE
KS
Enumeration date
07/15/2013
Last updated
04/14/2015
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