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General NPI Number Information
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NPI Number | 1881698850
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Entity Type | Individual
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Provider Name | EMILY CLARK JOHNSON MS, PT
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Gender | Female
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2929 LONDON BLVD
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City | PORTSMOUTH
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State | VA
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Zip | 23707-3405
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Country | US
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Telephone | 757-397-1201
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Fax | 757-398-0809
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Provider Business Mailing Address
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Address Line | PO BOX 7429
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City | PORTSMOUTH
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State | VA
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Zip | 23707-0429
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Country | US
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Telephone | 757-397-1201
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Fax | 757-398-0809
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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 | 2305004088
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License Number State | VA
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