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General NPI Number Information
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NPI Number | 1063325785
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Entity Type | Individual
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Provider Name | JOSIAH JOHNSON
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Gender | Male
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 3610 RANDOLPH RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1318
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Country | US
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Telephone | 704-486-2527
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E 36TH ST APT 537
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City | CHARLOTTE
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State | NC
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Zip | 28206-2650
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Country | US
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Telephone | 864-915-3732
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 15704
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License Number State | NC
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