Individual
MR. JAY MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED,ATC,LAT
Contact information
Practice address
1500 N PATTERSON ST, VALDOSTA, GA 31698-6982
(229) 333-5897
(229) 333-5205
Mailing address
1500 N PATTERSON ST, VALDOSTA, GA 31698-0100
(229) 333-5897
(229) 333-5205
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL 3434
FL
2255A2300X
Athletic Trainer
Primary
AT001259
GA
Other
Enumeration date
01/11/2007
Last updated
05/23/2019
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