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General NPI Number Information
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NPI Number | 1497775571
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Entity Type | Individual
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Provider Name | EMILY ANN JOHNSON ATC
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Gender | Female
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1034 GROVE ST MEADVILLE MEDICAL CENTER
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City | MEADVILLE
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State | PA
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Zip | 16335-2945
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Country | US
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Telephone | 814-333-5214
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Fax |
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Provider Business Mailing Address
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Address Line | 9897 KRIDER RD
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City | MEADVILLE
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State | PA
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Zip | 16335-6431
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Country | US
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Telephone | 814-724-1139
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT003219
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License Number State | PA
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