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General NPI Number Information
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NPI Number | 1508672668
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Entity Type | Individual
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Provider Name | NOLAN JOHNSON
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Gender | Male
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 1116 S MAIN ST
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City | MORGANTOWN
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State | KY
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Zip | 42261-9831
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Country | US
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Telephone | 270-526-2094
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Fax |
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Provider Business Mailing Address
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Address Line | 800 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-2347
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 009208
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License Number State | KY
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