Individual
LANEATRA DANETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5500 WILLIAMSBURG LANDING DR, WILLIAMSBURG, VA 23185-8079
(757) 258-2178
Mailing address
1010 PENNIMAN RD, WILLIAMSBURG, VA 23185-5416
(757) 318-1446
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602180
VA
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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