Individual
AUTUMN MCKENZIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT, LAT, ATC
Contact information
Practice address
4000 HIGHWAY 9 E, LITTLE RIVER, SC 29566-7833
(843) 390-8100
Mailing address
142 CAMBRIDGE DR, TABOR CITY, NC 28463-0609
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR.1854ATH
SC
Other
Enumeration date
01/14/2026
Last updated
01/14/2026
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