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NPI Code Detail

MEDICARE: MS. DEBRA H JOHNSON PT

MEDICARE: MS. DEBRA H JOHNSON PT
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
1225100000XPhysical Therapist975AL

General Provider Information

NPI Number : 1700948700
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBRA H JOHNSON PT
Provider Business Mailing Address
First Line : 5625 EDDINS RD
Second Line :
City : DOTHAN
State : AL
Zip : 36301-9575
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3763 ROSS CLARK CIR
Second Line :
City : DOTHAN
State : AL
Zip : 36303-2251
Country : US
Telephone Number : 334-673-2136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 07/08/2007

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Directions to “ MS. DEBRA H JOHNSON PT” Practice Location

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