Individual
TIMOTHY DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
2296 COUNTRY DR, FREMONT, CA 94536-5315
(510) 797-9299
Mailing address
5871 CRUMP CT, SAN JOSE, CA 95120-3824
(510) 468-6712
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT6097
CA
Other
Enumeration date
11/10/2006
Last updated
07/21/2014
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