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Individual

RICKEY R. JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
7601 PARKLANE RD, COLUMBIA, SC 29223-6122
(803) 741-9090
Mailing address
7601 PARKLANE RD, COLUMBIA, SC 29223-6122

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4136
SC

Other

Enumeration date
05/01/2019
Last updated
05/01/2019
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