Individual
TYRONE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4242 PINEFIELD CT, RANDALLSTOWN, MD 21133-5315
(443) 813-1555
Mailing address
4242 PINEFIELD CT, RANDALLSTOWN, MD 21133-5315
(443) 813-1555
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
225200000X
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A3356
PTA
MD
Enumeration date
09/13/2010
Last updated
09/13/2010
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