Doctor Name: | KELLY JOHNSON |
NPI Number: | 1194844480 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PTA |
License Number: | PTA 20669 |
Business Practice Address: | 807 N Tyndall Pkwy Panama City, FL - 324049495 |
Business Phone Number: | 8507630505 |
Business Fax Number: | 8507630966 |
Mailing Address: | 18345 April Ave, FOUNTAIN |
State: | FL |
Postal Code: | 324382456 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PTA 20669 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |