Individual
MRS. STEPHANIE J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
3825 SULLIVAN ST STE 4, MADISON, AL 35758
(256) 325-5400
(256) 325-5469
Mailing address
PO BOX 2138, MADISON, AL 35758-5416
(256) 325-5400
(256) 325-5469
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3076
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051531707
BLUE CROSS&BLUE SHIELD
AL
Enumeration date
08/08/2006
Last updated
08/07/2018
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