Individual
CAROL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
512 E COLUMBUS AVE, CORRY, PA 16407-9014
(814) 664-9346
(814) 663-0169
Mailing address
512 E COLUMBUS AVE, CORRY, PA 16407-9014
(814) 664-9346
(814) 663-0169
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PT000098E
PA
2251X0800X
Orthopedic Physical Therapist
Primary
PT000098E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025508801
LEGACY NUMBER - UNIVERA
NY
01
—
457211
LEGACY NUMBER - HIGHMARK
PA
Enumeration date
02/09/2006
Last updated
01/27/2010
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