Healthcare Provider Details

I. General information

NPI: 1730341587
Provider Name (Legal Business Name): NATALIE MARIE JOHNSON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MCCALLIE AVE
CHATTANOOGA TN
37404-3322
US

IV. Provider business mailing address

5004 DELASHMITT RD
HIXSON TN
37343-4214
US

V. Phone/Fax

Practice location:
  • Phone: 423-622-6200
  • Fax:
Mailing address:
  • Phone: 423-364-0874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8078
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: