Individual
AMANDA JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2413 PROFESSIONAL DR, ROCKY MOUNT, NC 27804-2254
(252) 443-0542
Mailing address
700B CROMWELL DR, GREENVILLE, NC 27858-5852
(252) 756-0009
(252) 355-7358
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10281
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201947869
TAX ID
NC
Enumeration date
07/07/2008
Last updated
12/22/2011
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