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Individual
MS. PENELOPE J JOHNSON
Active
Individual
MS. PENELOPE J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8030
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079YH
REHABILITATIVE MEDICINE
NC
01
—
186543
REHABILITATIVE MEDICINE
NC
01
—
807865
REHABILITATIVE MEDICINE
NC
Enumeration date
07/12/2006
Last updated
07/15/2021
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