Individual
NICHOLAS DEAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1650 PHILLIPS RD, TALLAHASSEE, FL 32308
(850) 942-9868
Mailing address
1827 IVAN DR, TALLAHASSEE, FL 32303
(904) 713-7762
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
24299
FL
Other
Enumeration date
06/06/2017
Last updated
06/06/2017
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