Individual
STUART TAKEO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4232
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228894
—
OR
Enumeration date
02/06/2007
Last updated
12/31/2012
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