Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119001536 | VA |
NPI | 1033492814 |
---|---|
Provider Name | Dr. Paige Marie Johns |
First Address | Bristow, VA 20136-1759 |
Second Address | Bristow, VA 20136-1759 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2011 |
Last Update Date | 27/09/2011 |