Doctor Name: | CAROL JOHNSON |
NPI Number: | 1134192164 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | PT000098E |
Business Practice Address: | 512 E Columbus Ave Corry, PA - 164079014 |
Business Phone Number: | 8146649346 |
Business Fax Number: | 8146630169 |
Mailing Address: | 512 E Columbus Ave, CORRY |
State: | PA |
Postal Code: | 164079014 |
Phone Number: | 8146649346 |
Fax Number: | 8146630169 |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 01/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | PT000098E |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |