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General NPI Number Information
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NPI Number | 1457918856
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Entity Type | Individual
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Provider Name | JAMES BENJAMIN JOHNSON PT
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Gender | Male
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 701 SAVANNAH RD
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City | LEWES
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State | DE
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Zip | 19958-1550
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Country | US
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Telephone | 302-644-2530
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Fax |
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Provider Business Mailing Address
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Address Line | 418 KINGS PARK DRIVE EXT APT B
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City | LIVERPOOL
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State | NY
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Zip | 13090-2776
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Country | US
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Telephone | 301-697-3345
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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