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Organization
PAUL JOHNSON PHYSICAL THERAPY, INC
Active
Organization
PAUL JOHNSON PHYSICAL THERAPY, INC
Active
Other names
STAR, Sports Training and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELBY RENEE BROWN (BUSINESS OFFICE MANAGER)
(707) 542-8313
Entity
Organization
Contact information
Practice address
3033 CLEVELAND AVE., 205, SANTA ROSA, CA 95403
(707) 542-8313
Mailing address
3033 CLEVELAND AVE., 205, SANTA ROSA, CA 95403
(707) 542-8313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ64164Z
BLUESHIELD
CA
Enumeration date
04/30/2007
Last updated
08/22/2020
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