| NPI | 1013627397 |
|---|---|
| Former Name | MADISON JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: CO PTL.0015344) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 205270) |
| 225100000X Physical Therapist (Licence: MN 12979) | |
| 225100000X Physical Therapist (Licence: HI PT56410) | |
| 225100000X Physical Therapist (Licence: NM 2023-2028) | |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2023-05-04 |