NPI | 1295701142 |
---|---|
Former Name | SARA LYNN JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 6462) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6730) |
Enumeration Date | 2006-02-28 |
Last Update Date | 2016-06-08 |