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General NPI Number Information
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NPI Number | 1336899327
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Entity Type | Individual
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Provider Name | DANA PLAUCHE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 1000 COMMERCE DR STE 200
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-3520
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Country | US
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Telephone | 770-740-1860
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20996
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City | BELFAST
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State | ME
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Zip | 04915-4106
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Country | US
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Telephone |
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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 | PTA004845
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License Number State | GA
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