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Individual

MR. SCOTT CHARLES JOHNSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
2280 DEERFIELD DR, FORT MILL, SC 29715-6941
(704) 357-8071
Mailing address
1501 MAJESTIC MEADOW DR, CHARLOTTE, NC 28216-9920
(704) 236-1904

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0852
NC

Other

Enumeration date
10/20/2005
Last updated
07/08/2007
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