| NPI | 1194454058 |
|---|---|
| Former Name | MACKENZIE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21317) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2025-08-18 |