Individual
KAELIN DANAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1 CHOCTAW WAY, TALIHINA, OK 74571-2022
(918) 567-7000
Mailing address
11726 SE 1040TH AVE, TALIHINA, OK 74571-6024
(918) 448-6622
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2930
OK
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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