Individual
MS. JESSICA RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
2160 COOLIDGE HWY, BERKLEY, MI 48072-1547
(248) 691-4700
Mailing address
2160 COOLIDGE HWY, BERKLEY, MI 48072-1547
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000661
MI
Other
Enumeration date
11/08/2017
Last updated
03/17/2018
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