Individual
TAMARA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
240 BRANCHVIEW DR NE, CONCORD, NC 28025-3498
(704) 723-4705
Mailing address
240 BRANCHVIEW DR NE, CONCORD, NC 28025-3498
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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