Jade Johnson, PTA

NPI #1962058008 in Winter Haven, Florida

Provider Information

NPI Number: 1962058008
Entity Type: Individual
Name: Jade Johnson, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 14, 2019
Last Updated: Aug 14, 2019

Practice Location

Address: 3050 WOODMONT AVE
City: Winter Haven
State: Florida
ZIP Code: 33884-3800
Phone: (727) 803-1102

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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