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General NPI Number Information
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NPI Number | 1124678966
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Entity Type | Individual
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Provider Name | JULIA ANNE JOHNSON CPTA
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Gender | Female
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 78078 COUNTRY CLUB DR STE 205
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City | BERMUDA DUNES
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State | CA
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Zip | 92203-8175
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Country | US
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Telephone | 760-272-1130
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Fax |
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Provider Business Mailing Address
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Address Line | 2707 APPLE LN
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City | HUTCHINSON
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State | KS
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Zip | 67502-1915
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Country | US
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Telephone | 620-314-1174
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 1403454
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License Number State | KS
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