NPI 1033463393

Katherine Johnson, PTA

Practitioner Physical Therapy Assistant Fairview Heights, IL

Practice location

Address: 320 N Ruby Ln, Fairview Heights, IL 62208
Phone: (618) 394-9798

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 160001794 (IL)

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Registry record

NPI: 1033463393
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Nov 2012
Record last updated: 7 Nov 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.