Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic | ||
Y | 2251X0800X | Physical Therapist - Orthopedic | 28354 | MD |
NPI | 1104416452 |
---|---|
Provider Name | Kathryn Elizabeth Johnson |
First Address | Eldersburg, MD 21784-8422 |
Second Address | Silver Spring, MD 20902-4665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2021 |
Last Update Date | 10/01/2022 |