Individual
ANGELIA M. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
10475 CENTURION PKWY N STE 220, JACKSONVILLE, FL 32256-5004
(904) 634-0640
(904) 634-0203
Mailing address
6500 BOWDEN RD STE 103, JACKSONVILLE, FL 32216-8066
(904) 634-0640
(904) 634-0203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT37966
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA27667
STATE LIC
FL
Enumeration date
08/25/2017
Last updated
11/12/2021
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