Provider Demographics
NPI:1083901052
Name:JOHNSON, ASHLEY (PT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6212
Mailing Address - Country:US
Mailing Address - Phone:412-554-0110
Mailing Address - Fax:
Practice Address - Street 1:4203 PA-66
Practice Address - Street 2:SUITE 102
Practice Address - City:APOLLO
Practice Address - State:PA
Practice Address - Zip Code:15613
Practice Address - Country:US
Practice Address - Phone:724-727-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist