Individual
ANDREW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
50 FODEN RD, SOUTH PORTLAND, ME 04106-1718
(207) 780-8860
(207) 780-8857
Mailing address
100 GANNETT DR STE C, SOUTH PORTLAND, ME 04106-5900
(207) 347-2947
(207) 874-2317
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1375
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061260
ANTHEM
—
05
—
267700099
—
ME
01
—
7970642
AETNA
—
Enumeration date
07/11/2006
Last updated
03/03/2026
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