Individual
BRIAN DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
7370 CABOT CT STE 101, MELBOURNE, FL 32940-8263
(321) 622-8792
Mailing address
496 KIMBERLY DR, MELBOURNE, FL 32940-7772
(301) 661-1549
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17614
FL
225XP0200X
Pediatric Occupational Therapist
OT17614
FL
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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