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1437677317
DETEVIA JOHNSON
TAMPA, FL
NPI
1437677317
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL AL4169)
Enumeration Date
2017-08-31
Last Update Date
2017-08-31
Business Address
DETEVIA JOHNSON MS, LAT, ATC
12701 SADDLE CLUB CIR APT 202
TAMPA, FL 33635-9689
Phone number: 850-691-7238
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Mailing Address
DETEVIA JOHNSON MS, LAT, ATC
12701 SADDLE CLUB CIR APT 202
TAMPA, FL 33635-9689
Phone number:
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