Individual
GAYLE A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
260 OLD OAK DR, CORTLAND, OH 44410-1122
(330) 638-1920
Mailing address
260 OLD OAK DR, CORTLAND, OH 44410-1122
(330) 638-1920
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA00854
OH
225200000X
Physical Therapy Assistant
TE001386L
PA
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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