Individual
JESSICA LEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4443 ROWAN RD, NEW PORT RICHEY, FL 34653-6198
(727) 846-9900
Mailing address
7642 85TH LN, LARGO, FL 33777-4340
(727) 687-4254
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29608
FL
Other
Enumeration date
11/01/2019
Last updated
11/01/2019
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