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Individual

MRS. KIMBERLY ERIN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
190 OLD ORCHARD SQ, ELLIJAY, GA 30540-8172
(706) 273-3131
(706) 273-3133
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 954-7408

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
01895
RI
225100000X
Physical Therapist
Primary
PT011319
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080001895RI01
ANTHEM
RI
01
1133771
AETNA
01
29777
NEIGHBORHOOD HEALTH
RI
01
297789
BCBS
RI
01
412111
BLUE CHIP
RI
01
709003312
MEDICARE PTAN
01
PT011319
PHYSICAL THERAPIST
GA
Enumeration date
04/05/2006
Last updated
11/27/2013
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