Individual
GARY WAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, LMT
Contact information
Practice address
987 NOHUNTA CT, CINCINNATI, OH 45231-2518
(513) 301-7193
Mailing address
987 NOHUNTA CT, CINCINNATI, OH 45231-2518
(513) 301-7193
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
013568
OH
225700000X
Massage Therapist
33.023867
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0779171
—
OH
Enumeration date
02/23/2012
Last updated
03/14/2018
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