Individual
ANGELA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4407 AMARILLO ST, BLYTHEVILLE, AR 72315-5702
(870) 532-2229
(870) 532-8237
Mailing address
1658 ECR 54, GOSNELL, AR 72315
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 1918
AR
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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