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NPI 1003025354

NPI 1003025354 : TERRI C JOHNS LMT, LE : SEBRING, FL

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General NPI Number Information
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    NPI Number           |    1003025354
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    Entity Type          |    Individual 
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    Provider Name        |    TERRI C JOHNS LMT, LE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/22/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1123 US HIGHWAY 27 S 
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    City                 |    SEBRING
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    State                |    FL
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    Zip                  |    33870-2171
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    Country              |    US
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    Telephone            |    863-382-6116
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1123 US HIGHWAY 27 S 
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    City                 |    SEBRING
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    State                |    FL
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    Zip                  |    33870-2171
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    Country              |    US
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    Telephone            |    863-382-6116
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    MA0016134
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    License Number State |    FL
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