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General NPI Number Information
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NPI Number | 1821436981
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Entity Type | Individual
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Provider Name | KATHERINE JO JOHNSON D.V.M.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 5624 STATE ROUTE 5
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City | HERKIMER
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State | NY
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Zip | 13350-3513
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Country | US
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Telephone | 315-866-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 111 BRIARWOOD DR APARTMENT 2
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City | ITHACA
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State | NY
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Zip | 14850-1978
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Country | US
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Telephone | 208-850-3538
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 012503
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License Number State | NY
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