Individual
MR. KEITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2301 MORNINGSIDE DR, JONESBORO, AR 72404-8050
(870) 680-2626
Mailing address
2301 MORNINGSIDE DR, JONESBORO, AR 72404-8050
(870) 680-2626
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 8230
TN
225100000X
Physical Therapist
Primary
PT1729
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133568721
—
AR
Enumeration date
12/28/2006
Last updated
04/30/2018
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