Individual
TAMARA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6550
NC
225200000X
Physical Therapy Assistant
PTA21747
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6550
NORTH CAROLINA
NC
01
—
PTA21747
FLORIDA
FL
Enumeration date
01/10/2012
Last updated
10/10/2018
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