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NPI Code Detail

MEDICARE: MRS. PAULA ANN JOHNSON PT, GTC, MBA

MEDICARE: MRS. PAULA ANN JOHNSON PT, GTC, MBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT-006657-LPA

General Provider Information

NPI Number : 1023151172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PAULA ANN JOHNSON PT, GTC, MBA
Provider Business Mailing Address
First Line : 6255 S HIGHLANDS CIR
Second Line :
City : HARRISBURG
State : PA
Zip : 17111-6940
Country : US
Telephone Number : 717-657-3046
Fax Number :
Provider Business Practice Location Address
First Line : 100 MOUNT ALLEN DR
Second Line :
City : MECHANICSBURG
State : PA
Zip : 17055-6171
Country : US
Telephone Number : 717-790-8225
Fax Number : 717-766-4794
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 12/08/2009

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