Individual
NICOLE R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
55 E PAULDING DR, DALLAS, GA 30157-7191
(470) 648-2038
Mailing address
55 E PAULDING DR, DALLAS, GA 30157-7191
(470) 648-2038
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA005142
GA
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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