Individual
MR. KEVIN KOEHLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1502 8TH AVE, BROOKLYN, NY 11215-5602
(718) 768-0002
Mailing address
1516 10TH AVE, BROOKLYN, NY 11215-5904
(347) 385-0998
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5050
WA
Other
Enumeration date
09/30/2005
Last updated
07/08/2007
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