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1265143093
MICHAEL SOUSA-JOHNSON
MARYVILLE, TN
NPI
1265143093
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TN 2972)
Enumeration Date
2022-12-13
Last Update Date
2022-12-13
Business Address
MICHAEL SOUSA-JOHNSON MS, LAT, ATC
502 E LAMAR ALEXANDER PKWY
MARYVILLE, TN 37804-5919
Phone number: 209-535-5176
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Mailing Address
MICHAEL SOUSA-JOHNSON MS, LAT, ATC
214 JUNIPER AVE
ALCOA, TN 37701-2828
Phone number: 209-535-5176
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