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Individual

JEREMY ALLEN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
2814 S BALTIMORE ST, KIRKSVILLE, MO 63501-4640
(660) 785-1834
(660) 785-1825
Mailing address
PO BOX C8502, KIRKSVILLE, MO 63501-8599
(660) 785-1834
(660) 785-1825

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2009014098
MO

Other

Enumeration date
06/24/2009
Last updated
08/19/2009
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