Individual
DOUGLAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
588 PAWTUCKET AVE, PAWTUCKET, RI 02860-6057
(401) 722-2400
(401) 728-3920
Mailing address
588 PAWTUCKET AVE, PAWTUCKET, RI 02860-6057
(401) 722-2400
(401) 728-3920
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00271-G
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780672709
GROUP NPI NUMBER
RI
01
—
PT02233
RI STATE LICENSE NUMBER
RI
Enumeration date
06/02/2009
Last updated
07/16/2009
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