MEDICARE: LINDSAY ERIN JOHNSON DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT009948	GA
2	225100000X	Physical Therapist	9483	TN

General Provider Information

NPI Number	:	1124339304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY ERIN JOHNSON DPT

Provider Business Mailing Address
First Line	:	3214 DAYTON BLVD STE B
Second Line	:
City	:	RED BANK
State	:	TN
Zip	:	37415-5047
Country	:	US
Telephone Number	:	423-876-8991
Fax Number	:

Provider Business Practice Location Address
First Line	:	3214 DAYTON BLVD STE B
Second Line	:
City	:	RED BANK
State	:	TN
Zip	:	37415-5047
Country	:	US
Telephone Number	:	423-876-8991
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2010
Last Update Date	:	03/07/2023

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