| NPI | 1073829297 |
|---|---|
| Former Name | KELLY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT37739) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT.012941) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2023-09-21 |