Shannon Elizabeth Johnson, PTA

NPI #1255858890 in Mequon, Wisconsin

Provider Information

NPI Number: 1255858890
Entity Type: Individual
Name: Shannon Elizabeth Johnson, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 24, 2017
Last Updated: Dec 13, 2021

Practice Location

Address: 12600 N PORT WASHINGTON RD
City: Mequon
State: Wisconsin
ZIP Code: 53092-3469
Phone: (262) 387-8800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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