Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist |
NPI | 1003094392 |
---|---|
Provider Name | Katrina F Johnson |
First Address | Anchorage, AK 99508-5926 |
Second Address | Anchorage, AK 99508-5926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2008 |
Last Update Date | 24/09/2008 |