Individual
MELISSA JILL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, ATC, CSCS
Contact information
Practice address
6920 MCGINNIS FERRY RD, SUITE 320, SUWANEE, GA 30024-1258
(770) 495-0610
Mailing address
3145 NEW UNIVERSITY TRL, CUMMING, GA 30041-1527
(678) 455-6391
(678) 455-6393
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5672
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
592156
BCBS GA
GA
Enumeration date
06/02/2006
Last updated
07/08/2007
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