Individual
KENNETH CLARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
7855 S EMERSON AVE, SUITE W, INDIANAPOLIS, IN 46237-8668
(317) 581-1890
(317) 581-2436
Mailing address
8902 N MERIDIAN ST, STE 215, INDIANAPOLIS, IN 46260-5382
(317) 581-1890
(317) 581-2436
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05005624A
IN
Other
Enumeration date
07/05/2006
Last updated
10/28/2014
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