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General NPI Number Information
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NPI Number | 1225180847
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Entity Type | Individual
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Provider Name | MARCELINA ANNETTE JOHNSON MPT
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 2167 QUAIL MEADOW LN
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City | FRISCO
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State | TX
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Zip | 75034-2621
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Country | US
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Telephone | 972-342-4210
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Fax | 972-797-0691
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Provider Business Mailing Address
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Address Line | 2167 QUAIL MEADOW LN
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City | FRISCO
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State | TX
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Zip | 75034-2621
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Country | US
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Telephone | 972-342-4210
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Fax | 972-797-0691
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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 | 1215863
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License Number State | TX
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