Individual
MARY W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
665 GAINES SCHOOL RD, ATHENS, GA 30605-3127
(706) 369-8115
Mailing address
665 GAINES SCHOOL RD, ATHENS, GA 30605-3127
(706) 369-8115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006469
GA
Other
Enumeration date
11/10/2008
Last updated
11/10/2008
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