Individual
LEDELL JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8855 HIGHWAY 90, MILTON, FL 32583-8383
(185) 060-2251
Mailing address
8855 HIGHWAY 90, MILTON, FL 32583-8383
(850) 602-2519
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA26405
FL
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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