Individual
SAMANTHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
444 ONE ELEVEN PL, COOKEVILLE, TN 38506-4358
(931) 525-6655
Mailing address
444 ONE ELEVEN PL, COOKEVILLE, TN 38506-4358
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4562
TN
Other
Enumeration date
03/22/2010
Last updated
03/22/2010
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