Individual
NICOLINA M JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6 COURTNEY DR, SEDGLEY OFFICE PARK, CHARLESTON, WV 25304-2696
(304) 720-5433
(304) 720-5436
Mailing address
6 COURTNEY DR, SEDGLEY OFFICE PARK, CHARLESTON, WV 25304-2696
(304) 720-5433
(304) 720-5436
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002120
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004820
—
WV
Enumeration date
09/20/2006
Last updated
07/08/2007
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