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NPI Code Detail

MEDICARE: VALARIE JOHNSON

MEDICARE:   VALARIE  JOHNSON
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 Therapist05007621AIN

General Provider Information

NPI Number : 1881850444
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALARIE JOHNSON
Provider Business Mailing Address
First Line : 3625 LAKESHORE CT
Second Line :
City : GREENWOOD
State : IN
Zip : 46143-8355
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 LIBRARY BLVD
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-1567
Country : US
Telephone Number : 317-881-9923
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2008
Last Update Date : 04/22/2012

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Directions to “ VALARIE JOHNSON ” Practice Location

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