Individual
JADE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3050 WOODMONT AVE, WINTER HAVEN, FL 33884-3800
(727) 803-1102
Mailing address
260 1ST AVE S STE 200, SAINT PETERSBURG, FL 33701-4364
(727) 803-1102
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29010
FL
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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