Provider Demographics
NPI:1023151172
Name:JOHNSON, PAULA ANN (PT, GTC, MBA)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PT, GTC, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 S HIGHLANDS CIR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-6940
Mailing Address - Country:US
Mailing Address - Phone:717-657-3046
Mailing Address - Fax:
Practice Address - Street 1:100 MOUNT ALLEN DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6171
Practice Address - Country:US
Practice Address - Phone:717-790-8225
Practice Address - Fax:717-766-4794
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-006657-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist