MEDICARE: LEIGH ANN JOHNSON LMBT

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	225700000X	Massage Therapist	11705	NC

General Provider Information

NPI Number	:	1215518667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH ANN JOHNSON LMBT

Provider Business Mailing Address
First Line	:	2058 RIVER VISTA LN
Second Line	:
City	:	GRAHAM
State	:	NC
Zip	:	27253-9881
Country	:	US
Telephone Number	:	919-619-6405
Fax Number	:

Provider Business Practice Location Address
First Line	:	4113 CAPITOL ST STE A
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-2390
Country	:	US
Telephone Number	:	919-750-0027
Fax Number	:

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

Provider Enumeration Date	:	04/17/2021
Last Update Date	:	04/17/2021

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Directions to “ LEIGH ANN JOHNSON LMBT” Practice Location

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