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General NPI Number Information
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NPI Number | 1306882485
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Entity Type | Individual
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Provider Name | RAYMOND JOHN JOHNSON P.T. M.P.T.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1345 EASTON RD
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City | ROSLYN
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State | PA
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Zip | 19001-2401
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Country | US
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Telephone | 215-885-2022
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Fax | 215-885-7408
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Provider Business Mailing Address
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Address Line | 226 GOODFORD RD
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City | PHILADELPHIA
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State | PA
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Zip | 19154-4322
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Country | US
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Telephone | 215-612-7992
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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 | PT008454L
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License Number State | PA
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