Healthcare Provider Details

I. General information

NPI: 1033508270
Provider Name (Legal Business Name): JOHNSON AUDIOLOGY OF CARTERSVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W MAIN ST
CARTERSVILLE GA
30120-3507
US

IV. Provider business mailing address

105 W MAIN ST
CARTERSVILLE GA
30120-3507
US

V. Phone/Fax

Practice location:
  • Phone: 770-334-3062
  • Fax:
Mailing address:
  • Phone: 770-334-3062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MEGAN JOHNSON
Title or Position: OWNER
Credential: AUD
Phone: 770-334-3062