Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT29029 | FL |
NPI | 1003223710 |
---|---|
Provider Name | Toni Ariana Johnson |
First Address | North Lauderdale, FL 33068-2226 |
Second Address | North Lauderdale, FL 33068-2226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2014 |
Last Update Date | 14/07/2014 |