NPI 1023152543

Gwanetia M Johnson, PTA

Practitioner Physical Therapy Assistant Columbia, SC

Practice location

Address: 2601 Forest Dr, Columbia, SC 29204-2363
Phone: (803) 765-7127
Mailing address: 504 Cambout St, Columbia, SC 29210-7121

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 1960 (SC)

Other Physical Therapy Assistant providers in South Carolina →

Registry record

NPI: 1023152543
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Feb 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.