Individual
MRS. IRMA YOLANDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
20402 N 15TH AVE, PHOENIX, AZ 85027-3636
(623) 445-4952
Mailing address
371 E. CATALINA AVENUE, PHOENIX, AZ 85012
(602) 912-0104
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2427
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2427
PHYSICAL THERAPY LIC.
AZ
01
—
596124
AHCCCS
AZ
Enumeration date
04/06/2007
Last updated
07/08/2007
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