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NPI Code Detail

MEDICARE: BRITTANY EVELYN JOHNSON C.P.

MEDICARE:   BRITTANY EVELYN JOHNSON  C.P.
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
1224P00000XProsthetist

General Provider Information

NPI Number : 1972980324
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY EVELYN JOHNSON C.P.
Provider Business Mailing Address
First Line : 123 PROFESSIONAL PARK DR
Second Line : STE 100
City : MOORESVILLE
State : NC
Zip : 28117-5524
Country : US
Telephone Number : 704-799-9825
Fax Number : 704-799-9826
Provider Business Practice Location Address
First Line : 123 PROFESSIONAL PARK DR
Second Line : STE 100
City : MOORESVILLE
State : NC
Zip : 28117-5524
Country : US
Telephone Number : 704-799-9825
Fax Number : 704-799-9826
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2015
Last Update Date : 05/05/2015

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Directions to “ BRITTANY EVELYN JOHNSON C.P.” Practice Location

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