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General NPI Number Information
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NPI Number | 1336366228
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Entity Type | Individual
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Provider Name | TAWANA JOHNSON DC
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 1400 BATTLEGROUND AVE SUITE 150A
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City | GREENSBORO
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State | NC
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Zip | 27408-8042
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Country | US
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Telephone | 336-272-1339
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Fax | 336-510-8605
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Provider Business Mailing Address
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Address Line | PO BOX 1915
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City | GREENSBORO
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State | NC
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Zip | 27402-1915
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Country | US
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Telephone | 336-272-1339
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Fax | 336-510-8605
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 3061
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License Number State | NC
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