Individual
RACINE E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT/OT
Contact information
Practice address
105 CLIFTWOOD DR, ATLANTA, GA 30328-4840
(770) 613-1201
(912) 205-3504
Mailing address
10216 PERIMETER PKWY # 9, CHARLOTTE, NC 28216-2461
(704) 808-0992
(704) 235-1973
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
11610
NC
225X00000X
Occupational Therapist
6889
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7302184
—
NC
01
—
Q399850281
MEDICARE
NC
Enumeration date
05/05/2008
Last updated
10/19/2021
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