Mary Johnson, PTA

NPI #1598974602 in Copiague, New York

Provider Information

NPI Number: 1598974602
Entity Type: Individual
Name: Mary Johnson, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PTA
Enumeration Date: May 22, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1160 MONTAUK HWY
City: Copiague
State: New York
ZIP Code: 11726-4904
Phone: (631) 842-4606

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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