Individual
NICK JASON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
799 DONE ROVEN RD, AUGUSTA, GA 30906-9757
(706) 755-2902
Mailing address
2601 PATRICIA DR LOT 76, BELLVIEW, FL 32526-3148
(803) 521-4028
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16716
FL
224Z00000X
Occupational Therapy Assistant
3478
SC
Other
Enumeration date
08/03/2015
Last updated
08/19/2021
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