Individual
THOMAS DALE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1930 E SOUTHERN AVE, TEMPE, AZ 85282-7518
(480) 456-0719
(480) 456-0163
Mailing address
1930 E SOUTHERN AVE, TEMPE, AZ 85282-7518
(480) 456-0719
(480) 456-0163
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
3282
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390279
—
AZ
Enumeration date
01/26/2007
Last updated
05/11/2018
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