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General NPI Number Information
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NPI Number | 1770284366
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Entity Type | Individual
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Provider Name | PIERCE JOHNSON LMT
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Gender | Male
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 3465 DULUTH HIGHWAY 120 APT 3409
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City | DULUTH
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State | GA
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Zip | 30096-3436
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Country | US
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Telephone | 770-316-3534
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 DUNWOODY VILLAGE PKWY UNIT 88043
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City | ATLANTA
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State | GA
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Zip | 30356-0007
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Country | US
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Telephone | 770-316-3534
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT014440
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License Number State | GA
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