Doctor Name: | ERIC JOHNSON |
NPI Number: | 1720263304 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 18614 |
Business Practice Address: | 12139 Mount Vernon Ave Grand Terrace, CA - 923135586 |
Business Phone Number: | 9093703396 |
Business Fax Number: | |
Mailing Address: | 12139 Mount Vernon Ave, GRAND TERRACE |
State: | CA |
Postal Code: | 923135586 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/02/2008 |
NPI Last Update Date: | 01/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 18614 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |