| Doctor Name: | MRS. JESSICA ANN JOHNSON |
| NPI Number: | 1659680700 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | UMT |
| License Number: | 2010-2725 |
| Business Practice Address: | 314 Goff Mountain Road Suite 13 Cross Lanes, WV - 25313 |
| Business Phone Number: | 3047765031 |
| Business Fax Number: | 3042046332 |
| Mailing Address: | 314 Goff Mountain Rd., Suite 13 CROSS LANES |
| State: | WV |
| Postal Code: | 25313 |
| Phone Number: | 3047765031 |
| Fax Number: | 3042046332 |
| NPI Enumeration Date: | 10/06/2010 |
| NPI Last Update Date: | 10/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | 2010-2725 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WV |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |