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General NPI Number Information
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NPI Number | 1205652112
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Entity Type | Individual
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Provider Name | ANNA JOHNSON PT
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Gender | Female
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 4647 ZION AVE
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City | SAN DIEGO
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State | CA
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Zip | 92120-2507
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Country | US
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Telephone | 732-796-4280
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 WOODMERE DR
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City | KEYPORT
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State | NJ
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Zip | 07735-5535
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Country | US
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Telephone | 732-796-4280
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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