Kalissa J Johnson, PTA

NPI #1376739318 in Vincennes, Indiana

Provider Information

NPI Number: 1376739318
Entity Type: Individual
Name: Kalissa J Johnson, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Sep 24, 2007
Last Updated: Sep 24, 2007

Practice Location

Address: 2121 WILLOW ST
City: Vincennes
State: Indiana
ZIP Code: 47591-5355
Phone: (812) 882-1141

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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