Individual
FRED ALLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
140 BRIMLEY DR, FREDERICKSBURG, VA 22406-5103
(540) 752-0001
Mailing address
1 KING GEORGE CV, RUTHER GLEN, VA 22546-5132
(804) 448-9618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
23O6603133
VA
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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