Individual
CHAVONE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4170 RUSH STREET, FAIRFAX, VA 22033-1809
(571) 294-3557
Mailing address
4170 RUSH ST, FAIRFAX, FAIRFAX, VA 22033-5524
(571) 294-3557
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
22054
MD
225100000X
Physical Therapist
Primary
2305204873
VA
Other
Enumeration date
12/20/2006
Last updated
07/19/2011
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