Individual
MRS. LAURIE JOHNSON
Active
Individual
MRS. LAURIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305003714
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008938741
—
VA
05
—
010380740
—
VA
05
—
010380758
—
VA
05
—
010380766
—
VA
05
—
010381207
—
VA
05
—
010381223
—
VA
Enumeration date
11/29/2005
Last updated
10/22/2010
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