| NPI | 1871151399 |
|---|---|
| Former Name | AMY LAURA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 04033) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: LA o4o33) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2025-09-23 |